Stimulated Thyroglobulin at Recombinant Human TSH-Aided Ablation Predicts Disease-free Status One Year Later

• Type: Article in International Scientific Journal
• Date: 2013

Authors

Miguel Melo (Author) Other; Gracinda Costa (Author) Other; Cristina Ribeiro (Author) Other; Francisco Carrilho (Author) Other; Maria Joao Martins (Author) Other; Adriana Gaspar da Rocha (Author) Other; Manuel Sobrinho Simoes (Author) FMUP; Manuela Carvalheiro (Author) Other; Paula Soares (Author) FMUP

Journal

Title: Journal of Clinical Endocrinology and Metabolism

Vol. 98

Pages: 4364-4372

ISSN: 0021-972X

Publisher: Endocrine Society

Indexing

ISI Web of Knowledge - 35 Citations

Scopus - 37 Citations

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Authenticus ID: P-008-GK4

DOI: 10.1210/jc.2013-2267

Abstract (EN): Context: Thyroglobulin (Tg) levels measured at the time of remnant ablation after thyroid hormone withdrawal (THW) were shown to have prognostic value in predicting disease-free status. Objectives: Our objectives were to determine whether stimulated Tg levels, measured at the time of remnant ablation performed under recombinant human TSH (rhTSH) stimulation, has value in predicting absence of detectable disease 1 year after radioiodine therapy and to compare the results obtained with this approach with a cohort of patients submitted to ablation after THW. Design: This was a prospective observational study. Setting and Patients: The study included 293 consecutive patients treated for a differentiated thyroid carcinoma with no initial evidence of distant metastasis. All patients were submitted to a total or near-total thyroidectomy, followed by ablation either under rhTSH (n = 151) or endogenous TSH stimulation (n = 142). Patients with positive Tg antibodies were excluded. Main Outcome Measures: The predictive value of Tg at ablation was assessed by receiver operating characteristic curve analysis. Results: In the rhTSH group, 96 patients (73.3%) were considered disease-free at 1 year. Stimulated Tg at ablation after rhTSH was found to be an independent prognostic indicator of disease persistence 12 months later. The highest-accuracy cutoff value for absence of detectable disease was defined as 7.2 ng/mL, with a negative predictive value of 90%. In the THW group, Tg at ablation also proved to have independent predictive value. Using the same threshold (7.2 ng/mL), the negative predictive value of Tg was 95% in the THW group. Conclusions: When rhTSH was used, stimulated Tg at ablation had independent predictive value for disease-free status 1 year later. A low stimulated Tg at rhTSH-aided ablation may be considered a favorable prognosis factor.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9