Abstract | BACKGROUND: Predictive role of undetectable thyroglobulin (Tg) in patients with poorly differentiated thyroid carcinoma ( PDTC) is unclear. Our goal was to report on Tg levels following total thyroidectomy and adjuvant RAI in PDTC patients and to correlate Tg levels with recurrence. METHODS: Forty patients with PDTC with no distant metastases at presentation (M0) and managed by total thyroidectomy and adjuvant RAI were identified from a database of 91 PDTC patients. Of these, 31 patients had Tg values recorded and formed the basis of our analysis. A nonstimulated Tg level <1 ng/ml was used as a cutoff point for undetectable Tg levels. Association of patient and tumor characteristics with Tg levels was examined by χ (2) test. Recurrence-free survival (RFS) stratified by postop Tg level was calculated by Kaplan-Meier method and compared by log-rank test. RESULTS: Twenty patients had undetectable Tg (<1 ng/ml) and 11 had detectable Tg (≥1 ng/ml; range 2-129 ng/ml) following surgery. After adjuvant RAI, 24 patients had undetectable Tg (<1 ng/ml) and 7 had detectable Tg (≥1 ng/ml; range 1-57 ng/ml). Patients with undetectable Tg were less likely to have pathologically positive margins compared to those with detectable Tg (33 vs. 72 % respectively; p = 0.03). Patients with undetectable Tg levels had better 5-year regional control and distant control than patients with detectable Tg level (5-year regional recurrence-free survival 96 vs. 69 %; p = 0.03; 5-year distant recurrence-free survival 96 vs. 46 %, p = 0.11). CONCLUSION: Postoperative thyroglobulin levels in subset of patients with PDTC appear to have predictive value for recurrence. Patients with undetectable Tg have a low rate of recurrence.
|
Authors | Tihana Ibrahimpasic, Ronald Ghossein, Diane L Carlson, Iain J Nixon, Frank L Palmer, Snehal G Patel, Robert M Tuttle, Ashok Shaha, Jatin P Shah, Ian Ganly |
Journal | Annals of surgical oncology
(Ann Surg Oncol)
Vol. 22
Issue 13
Pg. 4193-7
(Dec 2015)
ISSN: 1534-4681 [Electronic] United States |
PMID | 25893415
(Publication Type: Journal Article)
|
Chemical References |
- Biomarkers, Tumor
- Thyroglobulin
|
Topics |
- Adenocarcinoma, Follicular
(blood, pathology, surgery)
- Biomarkers, Tumor
(blood)
- Carcinoma, Papillary
(blood, pathology, surgery)
- Cell Differentiation
- Disease-Free Survival
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Neoplasm Staging
- Prognosis
- Retrospective Studies
- Thyroglobulin
(blood)
- Thyroid Neoplasms
(blood, pathology, surgery)
- Thyroidectomy
|