Identification of Intermediate- to High-Risk Papillary Thyroid Carcinoma Patients Who May Be Safely Managed without the Performance of Delayed Stimulated Thyroglobulin Measurements following Total Thyroidectomy and Radioactive Iodine Therapy
Background. The measurement of stimulated thyroglobulin (sTg) after total thyroidectomy and remnant radioactive iodine (RAI) ablation is the gold standard for monitoring disease status in patients with papillary thyroid carcinomas (PTCs). The aim of this study was to determine whether sTg measuremen...
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| Language: | English |
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Wiley
2015-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2015/318916 |
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| author | Kyung-Hee Kim Min-Hee Kim Ye-Jee Lim Ihn Suk Lee Ja-Seong Bae Dong-Jun Lim Ki Hyun Baek Jong Min Lee Moo-Il Kang Bong-Yun Cha |
| author_facet | Kyung-Hee Kim Min-Hee Kim Ye-Jee Lim Ihn Suk Lee Ja-Seong Bae Dong-Jun Lim Ki Hyun Baek Jong Min Lee Moo-Il Kang Bong-Yun Cha |
| author_sort | Kyung-Hee Kim |
| collection | DOAJ |
| description | Background. The measurement of stimulated thyroglobulin (sTg) after total thyroidectomy and remnant radioactive iodine (RAI) ablation is the gold standard for monitoring disease status in patients with papillary thyroid carcinomas (PTCs). The aim of this study was to determine whether sTg measurement during follow-up can be avoided in intermediate- and high-risk PTC patients. Methods. A total of 346 patients with PTCs with an intermediate or high risk of recurrence were analysed. All of the patients underwent total thyroidectomy as well as remnant RAI ablation and sTg measurements. Preoperative and postoperative parameters were included in the analysis. Results. Among the preoperative parameters, age below 45 years and preoperative Tg above 19.4 ng/mL were significant risk factors for predicting detectable sTg during follow-up. Among the postoperative parameters, thyroid capsular invasion, lymph node metastasis, and ablative Tg above 2.9 ng/mL were independently correlated with a detectable sTg range. The combination of ablative Tg less than 2.9 ng/mL with pre- and postoperative independent risk factors for detectable sTg increased the negative predictive value for detectable sTg up to 98.5%. Conclusions. Based on pre- and postoperative parameters, a substantial proportion of patients with PTCs in the intermediate- and high-risk classes could avoid aggressive follow-up measures. |
| format | Article |
| id | doaj-art-c573b27db36a4e28997d83a2cc8422f7 |
| institution | DOAJ |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-c573b27db36a4e28997d83a2cc8422f72025-08-20T03:22:44ZengWileyInternational Journal of Endocrinology1687-83371687-83452015-01-01201510.1155/2015/318916318916Identification of Intermediate- to High-Risk Papillary Thyroid Carcinoma Patients Who May Be Safely Managed without the Performance of Delayed Stimulated Thyroglobulin Measurements following Total Thyroidectomy and Radioactive Iodine TherapyKyung-Hee Kim0Min-Hee Kim1Ye-Jee Lim2Ihn Suk Lee3Ja-Seong Bae4Dong-Jun Lim5Ki Hyun Baek6Jong Min Lee7Moo-Il Kang8Bong-Yun Cha9Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, No. 505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Republic of KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, No. 505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Republic of KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, No. 505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Republic of KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, No. 505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Republic of KoreaDepartment of Surgery, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul 137-701, Republic of KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, No. 505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Republic of KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, No. 505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Republic of KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, No. 505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Republic of KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, No. 505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Republic of KoreaDivision of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, No. 505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Republic of KoreaBackground. The measurement of stimulated thyroglobulin (sTg) after total thyroidectomy and remnant radioactive iodine (RAI) ablation is the gold standard for monitoring disease status in patients with papillary thyroid carcinomas (PTCs). The aim of this study was to determine whether sTg measurement during follow-up can be avoided in intermediate- and high-risk PTC patients. Methods. A total of 346 patients with PTCs with an intermediate or high risk of recurrence were analysed. All of the patients underwent total thyroidectomy as well as remnant RAI ablation and sTg measurements. Preoperative and postoperative parameters were included in the analysis. Results. Among the preoperative parameters, age below 45 years and preoperative Tg above 19.4 ng/mL were significant risk factors for predicting detectable sTg during follow-up. Among the postoperative parameters, thyroid capsular invasion, lymph node metastasis, and ablative Tg above 2.9 ng/mL were independently correlated with a detectable sTg range. The combination of ablative Tg less than 2.9 ng/mL with pre- and postoperative independent risk factors for detectable sTg increased the negative predictive value for detectable sTg up to 98.5%. Conclusions. Based on pre- and postoperative parameters, a substantial proportion of patients with PTCs in the intermediate- and high-risk classes could avoid aggressive follow-up measures.http://dx.doi.org/10.1155/2015/318916 |
| spellingShingle | Kyung-Hee Kim Min-Hee Kim Ye-Jee Lim Ihn Suk Lee Ja-Seong Bae Dong-Jun Lim Ki Hyun Baek Jong Min Lee Moo-Il Kang Bong-Yun Cha Identification of Intermediate- to High-Risk Papillary Thyroid Carcinoma Patients Who May Be Safely Managed without the Performance of Delayed Stimulated Thyroglobulin Measurements following Total Thyroidectomy and Radioactive Iodine Therapy International Journal of Endocrinology |
| title | Identification of Intermediate- to High-Risk Papillary Thyroid Carcinoma Patients Who May Be Safely Managed without the Performance of Delayed Stimulated Thyroglobulin Measurements following Total Thyroidectomy and Radioactive Iodine Therapy |
| title_full | Identification of Intermediate- to High-Risk Papillary Thyroid Carcinoma Patients Who May Be Safely Managed without the Performance of Delayed Stimulated Thyroglobulin Measurements following Total Thyroidectomy and Radioactive Iodine Therapy |
| title_fullStr | Identification of Intermediate- to High-Risk Papillary Thyroid Carcinoma Patients Who May Be Safely Managed without the Performance of Delayed Stimulated Thyroglobulin Measurements following Total Thyroidectomy and Radioactive Iodine Therapy |
| title_full_unstemmed | Identification of Intermediate- to High-Risk Papillary Thyroid Carcinoma Patients Who May Be Safely Managed without the Performance of Delayed Stimulated Thyroglobulin Measurements following Total Thyroidectomy and Radioactive Iodine Therapy |
| title_short | Identification of Intermediate- to High-Risk Papillary Thyroid Carcinoma Patients Who May Be Safely Managed without the Performance of Delayed Stimulated Thyroglobulin Measurements following Total Thyroidectomy and Radioactive Iodine Therapy |
| title_sort | identification of intermediate to high risk papillary thyroid carcinoma patients who may be safely managed without the performance of delayed stimulated thyroglobulin measurements following total thyroidectomy and radioactive iodine therapy |
| url | http://dx.doi.org/10.1155/2015/318916 |
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