Post-operative stimulated thyroglobulin and neck ultrasound as personalized criteria for risk stratification and radioactive iodine selection in low- and intermediate-risk papillary thyroid cancer

Endocrine
Steven OrlovPaul G Walfish

Abstract

The purpose of this study was to demonstrate the utility of a personalized risk stratification and radioactive iodine (RAI) selection protocol (PRSP) using post-operative stimulated thyroglobulin (Stim-Tg) and neck ultrasound in low- and intermediate-risk papillary thyroid carcinoma (PTC) patients. Patients with PTC tumors ≥1 cm were prospectively followed after total thyroidectomy and selective therapeutic central compartment neck dissection. Low/intermediate risk was defined as PTC confined to the thyroid or central (level VI) lymph nodes. Stim-Tg and neck ultrasound were performed approximately 3 months after surgery and used to guide RAI selection. Patients with Stim-Tg < 1 µg/L did not receive RAI, while those with Stim-Tg >5 µg/L routinely did. Those with Stim-Tg 1-5 µg/L received RAI on the basis of several clinical risk factors. Patients were followed for >6 years with serial neck ultrasound and basal/stimulated thyroglobulin. Among the 129 patients, 84 (65 %) had undetectable Stim-Tg after initial surgery, 40 (31 %) had Stim-Tg of 1-5 µg/L, and 5 (4 %) had Stim-Tg >5 µg/L. RAI was administered to 8 (20 %) patients with Stim-Tg 1-5 µg/L and 5 (100 %) with Stim-Tg >5 µg/L. Using this approach, RAI therapy was avoided in ...Continue Reading

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Citations

Oct 28, 2015·Endocrine-related Cancer·Gabriela Franco MourãoMaria Regina Calsolari
Feb 26, 2016·Archives of Endocrinology and Metabolism·Pedro Weslley Rosario, Gabriela Franco Mourão
Feb 26, 2016·Archives of Endocrinology and Metabolism·Rosalia do Prado Padovani
Mar 27, 2019·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Tian TianBin Liu
Jun 22, 2017·Endocrine Reviews·Megan R HaymartJulia Ann Sosa
Jan 23, 2020·Thyroid : Official Journal of the American Thyroid Association·Lina LiuBin Liu
Dec 16, 2016·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Ying HeLing-Ge Wei
Jun 3, 2021·Cancers·Klaas Van Den HeedeFausto F Palazzo

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