title: Recombinant human thyrotropin-stimulated thyroglobulin level at the time of radioactive iodine ablation is an independent prognostic marker of differentiated thyroid carcinoma in the setting of prophylactic central neck dissection.
abstract: We investigated the value of the stimulated thyroglobulin (Tg) level at the time of recombinant human thyrotropin (rhTSH)-aided remnant ablation for predicting disease status 1 year later in patients with DTC who underwent total thyroidectomy with central neck dissection (CND).
  
  
  
  This was a prospective observational study of 253 consecutive patients with DTC who underwent rhTSH-aided RAI ablation after total thyroidectomy and prophylactic CND. Patients with evidence of initial distant metastasis or positive Tg antibodies were excluded.
  
  
  
  We compared rhTSH-stimulated Tg level at RAI ablation according to the disease status at 1 year and evaluated optimal cut-off value of rhTSH-stimulated Tg. Binary logistic regression analysis was performed to investigate the independent predictive factors for disease status 1 year after ablation.
  
  
  
  Among study participants, 228 (90·1%) were considered disease free at 1 year after remnant ablation. Patients with persistent or recurrent disease were more likely to be aged ≥45 years, and to have N1b stage, TNM stage III or IV, and higher rhTSH-stimulated Tg level at RAI ablation. The optimal cut-off of rhTSH-stimulated Tg for predicting persistent or recurrent disease was 1·79 ng/ml, with a negative predictive value of 99·5%. A serum rhTSH-stimulated Tg level ≥1·79 at the time of ablation was independently associated with persistent or recurrent disease 1 year later. N1b stage tended to be associated with persistent or recurrent disease.
  
  
  
  A low stimulated serum Tg level at rhTSH-aided RAI ablation may be a favourable prognostic marker in the setting of prophylactic CND.
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Korea.
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Moon
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Korea.
authors.forename: June Young
authors.initials: JY
authors.lastname: Choi
authors.affiliation: Department of Otorhinolaryngology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Korea.
authors.forename: Woo-Jin
authors.initials: WJ
authors.lastname: Jeong
authors.affiliation: Department of Otorhinolaryngology, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Korea.
authors.forename: Soon-Hyun
authors.initials: SH
authors.lastname: Ahn
authors.affiliation: Department of Nuclear Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, Korea.
authors.forename: Won Woo
authors.initials: WW
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Korea.
authors.forename: Kyoung Min
authors.initials: KM
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Korea.
authors.forename: Sung Hee
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Korea.
authors.forename: Soo
authors.initials: S
authors.lastname: Lim
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Seoul National University Boramae Medical Center and Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Ka Hee
authors.initials: KH
authors.lastname: Yi
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Do Joon
authors.initials: do J
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam-si, Korea.
authors.forename: Hak Chul
authors.initials: HC
authors.lastname: Jang
mesh_terms: D055011:Ablation Techniques / Q000379:methods; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods; D011379:Prognosis; D011994:Recombinant Proteins / Q000494:pharmacology; D013954:Thyroglobulin / Q000097:blood*; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery; D013972:Thyrotropin / Q000494:pharmacology*
chemical_list: D007457:Iodine Radioisotopes; D011994:Recombinant Proteins; D013972:Thyrotropin; D013954:Thyroglobulin