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.
abstract: 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.
authors: Division 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 Korea.
authors: Kyung-Hee
authors: KH
authors: Kim
authors: Division 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 Korea.
authors: Min-Hee
authors: MH
authors: Kim
authors: Division 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 Korea.
authors: Ye-Jee
authors: YJ
authors: Lim
authors: Division 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 Korea.
authors: Ihn Suk
authors: IS
authors: Lee
authors: Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul 137-701, Republic of Korea.
authors: Ja-Seong
authors: JS
authors: Bae
authors: Division 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 Korea.
authors: Dong-Jun
authors: DJ
authors: Lim
authors: Division 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 Korea.
authors: Ki Hyun
authors: KH
authors: Baek
authors: Division 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 Korea.
authors: Jong Min
authors: 0000-0001-5418-8051
authors: JM
authors: Lee
authors: Division 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 Korea.
authors: Moo-Il
authors: MI
authors: Kang
authors: Division 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 Korea.
authors: Bong-Yun
authors: BY
authors: Cha
references: Thyroid. 1997 Aug;7(4):613-9
references: 9292951
references: Surgery. 2006 Dec;140(6):1000-5; discussion 1005-7
references: 17188149
references: J Otolaryngol Head Neck Surg. 2010 Dec;39(6):669-73
references: 21144363
references: Cancer. 2006 Feb 1;106(3):524-31
references: 16369995
references: Cancer. 1997 Jun 15;79(12):2414-23
references: 9191532
references: J Korean Med Sci. 2012 Sep;27(9):1014-8
references: 22969246
references: Clin Nucl Med. 2012 Jun;37(6):545-9
references: 22614184
references: Thyroid. 2010 Dec;20(12):1341-9
references: 21034228
references: J Clin Oncol. 2009 Jun 20;27(18):2977-82
references: 19414674
references: Thyroid. 2009 Nov;19(11):1167-214
references: 19860577
references: J Clin Endocrinol Metab. 2004 Jul;89(7):3402-7
references: 15240622
references: Ann Surg. 2003 Feb;237(2):227-34
references: 12560781
references: Hum Pathol. 2000 Apr;31(4):428-33
references: 10821488
references: Eur J Endocrinol. 2006 Jun;154(6):787-803
references: 16728537
references: Thyroid. 2005 Sep;15(9):1041-5
references: 16187912
references: Clin Endocrinol (Oxf). 2007 Jan;66(1):58-64
references: 17201802
references: Ann Surg Oncol. 2013 Mar;20(3):733-8
references: 23224826
references: J Clin Endocrinol Metab. 2013 Nov;98(11):4364-72
references: 24037891
references: Surgery. 2013 Jun;153(6):828-35
references: 23489940
references: Horm Metab Res. 2013 Sep;45(9):664-8
references: 23720229
references: Thyroid. 2013 Jan;23(1):58-63
references: 22973946
references: Am Surg. 2005 Sep;71(9):731-4
references: 16468507
references: Thyroid. 2002 Aug;12 (8):707-11
references: 12225639
references: J Clin Endocrinol Metab. 1990 Aug;71(2):414-24
references: 2380337
references: Thyroid. 2012 Nov;22(11):1140-3
references: 23050786
references: J Clin Endocrinol Metab. 2008 Jan;93(1):76-81
references: 17971424
references: Ann Surg. 1998 Sep;228(3):320-30
references: 9742915
references: World J Surg. 2006 Oct;30(10):1821-8
references: 16983469
references: Korean J Intern Med. 2010 Dec;25(4):408-14
references: 21179279
references: J Clin Endocrinol Metab. 2014 Feb;99(2):440-7
references: 24285679
references: J Clin Endocrinol Metab. 2002 Apr;87(4):1490-8
references: 11932270
references: Ann Nucl Med. 2012 Dec;26(10):777-86
references: 22869417
references: Thyroid. 2006 Feb;16(2):177-9
references: 16676403
references: Cancer. 2011 Jan 15;117(2):259-67
references: 20824721
references: Surgery. 2010 Dec;148(6):1139-45; discussion 1145-6
references: 21134544
references: Cancer Biother Radiopharm. 2002 Oct;17(5):507-14
references: 12470420