scholarly journals Thyroglobulin value in patients surgically treated for differentiated thyroid carcinoma

2016 ◽  
Vol 144 (7-8) ◽  
pp. 397-401
Author(s):  
Gostimir Mikac ◽  
Sinisa Stankovic
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Differentiated Thyroid Cancer ◽  
Differentiated Thyroid Carcinoma ◽  
Average Value ◽  
Radioiodine Ablation ◽  
Individual Variations ◽  
Significant Difference ◽  
Node Metastases ◽  
One Year

Introduction. Thyroglobulin is composed glycoprotein, and it is synthesized by follicular cells of the thyroid gland. Treatment of differentiated thyroid carcinomas involves total thyroidectomy followed by radioiodine ablation of a potential remaining tissue. The measurement of thyroglobulin in the postoperative follow-up can serve as an indicator of tumor growth or recurrence of the disease. Objective. The aim of this paper is to examine the value of thyroglobulin in patients surgically treated for differentiated thyroid cancer who had metastases in the lymph nodes of the neck, as well as in operated on patients without any evident metastasis. Methods. Thyroglobulin values in the serum of 58 patients were analyzed. Two groups were formed. The thyroglobulin value was established with the use of IRMA-hTg (125I) system. Normal levels of thyroglobulin were from 2 ng/ml to 65 ng/ml. For all of 58 patients, thyroglobulin was determined three times. The first, so-called pre-ablation thyroglobulin was determined immediately before the application of 131I ablation dose. The second and the third measurements were conducted six to eight months and one year, respectively, after the application of the ablation dose respectively. Results. The first group consisted of 14 patients with histologically proven metastases in the lymph nodes of the neck, while the second group consisted of 44 patients without any evident metastases. The average thyroglobulin value of pre-ablation in the patients from the first group was 43.45 ng/ml, while in the second was 7.57 ng/ml. Levene?s test (with p = 0.00, i.e p < 0.05), demonstrated a statistically significant difference. Furthermore, in both groups, there was statistically significant difference between pre-ablation and post-ablation thyroglobulin values (Student?s t-test with p < 0.05). Conclusion It can be concluded that the average value of thyroglobulin was significantly higher in patients with lymph node metastases in the neck. We are of the opinion that the determination of thyroglobulin, despite individual variations, may serve as a good indicator to assist in monitoring of patients surgically treated for differentiated thyroid cancer.

scholarly journals The role of Hashimoto thyroiditis in predicting radioiodine ablation efficacy and prognosis of low to intermediate risk differentiated thyroid cancer

2021 ◽  
Author(s):  
Domenico Albano ◽  
Francesco Dondi ◽  
Valentina Zilioli ◽  
Maria Beatrice Panarotto ◽  
Alessandro Galani ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Treatment Response ◽  
Differentiated Thyroid Cancer ◽  
Hashimoto Thyroiditis ◽  
Prognostic Impact ◽  
Intermediate Risk ◽  
Excellent Response ◽  
Radioiodine Ablation ◽  
One Year

Abstract Objective The baseline treatment of differentiated thyroid cancer (DTC) consists of thyroidectomy followed by postoperative risk-adapted radioiodine therapy (RAIT) when indicated. The choice of most appropriate RAI activities to administer with the aim to reach an efficient remnant ablation and reduce the risk of recurrence is yet an open issue and the detection of basal factors that may predict treatment response seems fundamental. The aim of this study was to investigate the potential role of Hashimoto thyroiditis (HT) in predicting 1-year and 5-year treatment response after RAIT and prognosis. Methods We retrospectively included 314 consecutive patients (174 low-risk and 140 intermediate-risk) who received thyroidectomy plus RAIT. One-year and 5-year disease status was evaluated according to 2015 ATA categories response based upon biochemical and structural findings. Results HT was reported histopathologically in 120 patients (38%). DTC patients with concomitant HT received a higher number of RAITs and cumulative RAI activities. Initial RAIT reached an excellent response in 63% after one year and 84% after 5 years. The rate of excellent response one year and 5-year after first RAIT was significantly lower in HT groups, compared to not HT (p < 0.001). Instead, HT did not have a prognostic role considering PFS and OS; while stimulate thyroglobulin (sTg) at ablation was significantly related to survival. Conclusions HT may affect the efficacy of RAIT in low to intermediate risk DTC, particularly reducing the successful rate of excellent response after RAIT. Instead, HT did not have a prognostic impact such as stimulated sTg.

scholarly journals The Efficacy of Thyrotropin Suppression Therapy in Treatment of Differentiated Thyroid Cancer after Total Thyroidectomy

2015 ◽  
Vol 6 (2) ◽  
pp. 24-33
Author(s):  
Niveen A. Abo-Touk ◽  
Dalia H. Zayed
Keyword(s):  
Thyroid Cancer ◽  
High Risk ◽  
Thyroid Carcinoma ◽  
Differentiated Thyroid Cancer ◽  
Tumour Size ◽  
Differentiated Thyroid Carcinoma ◽  
Tsh Suppression ◽  
Significant Difference ◽  
Tsh Suppression Therapy ◽  
Disease Free

AbstractBackground: The aim of this prospective study was to assess the effect of the TSH suppression on both disease-free and overall survivals in patients with nonmetastatic differentiated thyroid cancer (DTC) after total thyroidectomy.Patients & Methods: One hundred and forty eight patients with pathologically proved operable differentiated thyroid carcinoma were enrolled in this prospective study. Levothyroxin (L-T4) therapy was started in doses according to treatment groups. Patients were randomly assigned to receive either postoperative TSH suppression therapy in group I (76 patients) or nonsuppression therapy in group II (72 patients).Results: During the period of follow up with a median 54 months, the disease-free survival for patients without TSH suppression therapy did not reach statistically significant difference comparing with those for patients with the suppression therapy (p=0.09). However, the difference was statistically significant for high-risk patients (p=0.04). On comparing both groups there was no statistically significant difference with regard to overall survival (p=0.17). The age of the patients more than 45 years, tumour size more than 4 cm and high-risk group were significant independent predictors for thyroid carcinoma-related relapse in univariate analysis. However, tumour size was the only significant factor in multivariate analysis.Conclusion: Suppressive treatment with L-T4 therapy in patients with differentiated thyroid carcinoma should be individualised and balanced against the adverse effects. TSH suppression is indicated in patients with high-risk disease or recurrent tumour. Normalisation of serum TSH is preferred for long-term treatment of disease-free elderly patients with DTC and comorbidities.

scholarly journals Reduction of overtreatment without reduction of overdiagnosis in patients with differentiated thyroid cancer: mission impossible

2021 ◽  
Author(s):  
Tjasa Oblak ◽  
Andraz Perhavec ◽  
Marko Hocevar ◽  
Barbara Peric
Keyword(s):  
Multivariate Analysis ◽  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Differentiated Thyroid Cancer ◽  
Regional Recurrence ◽  
Cervical Lymph Nodes ◽  
Term Survival ◽  
Less Is More ◽  
Significant Difference ◽  
Multiple Variables

Abstract Purpose Lateral neck nodal metastases are common in patients with differentiated thyroid cancer (DTC) and usually have an indolent nature. They may be detected via neck palpation or preoperative ultrasound (US) of the neck. We hypothesized that preoperative neck metastases detected with US did not affect regional recurrence or long-term survival. Methods A retrospective analysis of patients’ records treated for DTC at our institution between January 2006 and December 2016 was performed. Information about preoperative US of the neck, treatment, demographics, staging, and histopathology was obtained. The endpoints for the study were nodal recurrence and survival. Differences in survival were analyzed between three groups of patients divided by presence or lack of preoperative US and/or palpable cervical lymph nodes (PLN). Furthermore, the prognostic value of multiple variables was tested by univariate and multivariate analysis. Results There were 1108 patients with DTC, 221 males and 887 females. The median age was 48.3 years (range 3 to 86), the median time of observation was 68 months (range 0 to 142). Eight hundred sixty-two patients without PLN or preoperative US represented group 1, 112 patients with PLN were in group 2, and 134 patients without PLN and with preoperative US were in group 3. Only five patients had a regional recurrence, one died due to distant metastases. There was no statistically significant difference in survival between the groups (p = 0.841) and neck US was not significantly associated with overall survival neither in univariate nor in multivariate analysis. Conclusion In patients with DTC, the benefits of preoperative US of cervical lymph nodes are probably limited and “less is more” approach is advised.

124I-PET/CT images of differentiated thyroid cancer patients

2012 ◽  
Vol 51 (06) ◽  
pp. 213-216 ◽  
Author(s):  
S. Rosenbaum-Krumme ◽  
J. Nagarajah ◽  
M. Ruhlmann ◽  
A. Bockisch ◽  
W. Jentzen
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Activity Concentration ◽  
Thyroid Stimulating Hormone ◽  
Maximum Activity ◽  
Correct Assignment ◽  
Pet Ct ◽  
Significant Difference ◽  
Node Metastases ◽  
Ct Data

SummaryFor an adequate therapy planning and staging of patients with differentiated thyroid cancer (DTC), the correct assignment of thyroid remnants (TRs) and lymph node metastases (LMs) is important. Patients, method: We retrospectively analyzed whether kinetic quantities can help improving LM assignment using serial 124I-PET/CT data. 127 patients with a total of 317 lesions (TR: n = 265; LM: n = 52) received pre-therapy 124I-PET/CT lesion dosimetry using images 24 h and > 96 h after 124I administration. For each lesion, maximum activity concentration (MAC) at 24 h and effective half-life (EHL) were determined. Moreover, the product of MAC and EHL was also investigated as a quantity and is referred to CAQ (cumulated activity proportional quantity). In addition, differences between endogenous and exogenous thyroid-stimulating hormone (TSH) stimulation and between papillary (PTC) and follicular thyroid cancer (FTC) were investigated. Results, conclusion: The median MAC, EHL, and CAQ values in TR were significantly higher than in LM but a clinically relevant cut-off value could not be determined because of high overlapping regions. No significant differences for the three quantities were found for the mode of TSH stimulations, but a significant difference for MAC and CAQ between PTC and FTC.

Should Treatment of Highly Differentiated Thyroid Carcinoma Be Conservative?

1983 ◽  
Vol 22 (01) ◽  
pp. 20-23 ◽  
Author(s):  
B. Helpap ◽  
U. Koch ◽  
R. Janson ◽  
C. Baumgarten ◽  
C. Winkler ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Thyroid Carcinoma ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Thyroid Tissue ◽  
Differentiated Thyroid Carcinoma ◽  
Therapeutic Concept ◽  
Regional Metastases ◽  
Node Metastases

On the basis of three selected cases (one with clinically occult follicular and two with metastatic papillary carcinoma) the necessity of a comprehensive therapeutic concept even in highly differentiated thyroid cancer is stressed. Thyroid tissue and regional metastases should be eliminated by surgery, followed by radioiodine therapy in any event. Radiation teletherapy should be reserved to patients with invasive tumor growth exceeding the organ capsule, with lymph node metastases, and with massive angioinvasive growth.

Procedure guideline for radioiodine therapy and 131iodine whole-body scintigraphy in paediatric patients with differentiated thyroid cancer

2007 ◽  
Vol 46 (05) ◽  
pp. 224-231 ◽  
Author(s):  
M. Dietlein ◽  
M. Biermann ◽  
M. Frühwald ◽  
T. Linden ◽  
P. Bucsky ◽  
...  
Keyword(s):  
Body Weight ◽  
Thyroid Cancer ◽  
Thyroid Hormones ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Whole Body ◽  
Paediatric Patients ◽  
Procedure Guidelines ◽  
Radioiodine Ablation ◽  
Node Metastases

SummaryThe procedure guideline for radioiodine (131I) therapy and 131I whole-body scintigraphy of differentiated thyroid cancer in paediatric patients is the counterpart to the procedure guidelines (version 3) for adult patients and specify the interdisciplinary guideline for thyroid cancer of the Deutsche Krebsgesellschaft concerning the nuclear medicine part. Characteristics of thyroid cancer in children are the higher aggressiveness of papillary thyroid cancer, the higher frequency of extrathyroidal extension and of disseminated pulmonary metastases as well as the high risk of local recurrences. Radioiodine therapy is generally recommended in children, the 131I activity depends on the children's body weight. Radioiodine ablation in children with small papillary cancer (≤1 cm) should be considered. TSH stimulation is reached two weeks (children) or three weeks (adolescents) after withdrawal of thyroid hormones. Anti-emetic drugs are highly recommended. CT of the chest and examination of pulmonary function are clearly indicated if there is any suspicion on metastases. 3–6 months after 131I ablation, the 131I whole-body scintigraphy is highly recommended as lymph node metastases are frequently detected in paediatric patients. Follow-up care should be arranged in shorter intervals than in adults to test the compliance and to adapt dosage of thyroid hormones to the children's body weight. Reference values of fT3 are higher in children than in adults. Evidence is insufficient to describe in which constellation the TSH may be kept within the low normal level. Therefore, TSH suppression is generally recommended.

Relationship between Thyroglobulin and Tumor Detectabilily with Thallium-201 in Differentiated Thyroid Cancer

2000 ◽  
Vol 39 (01) ◽  
pp. 10-15 ◽  
Author(s):  
S. P. Müller ◽  
Ch. Reiners ◽  
A. Bockisch ◽  
Katja Brandt-Mainz
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Roc Analysis ◽  
Tsh Suppression ◽  
Significant Difference ◽  
Test Specificity ◽  
The Relationship ◽  
Tumor Scintigraphy ◽  
Tsh Stimulation

Summary Aim: Tumor scintigraphy with 201-TICI is an established diagnostic method in the follow-up of differentiated thyroid cancer. We investigated the relationship between thyroglobulin (Tg) level and tumor detectability. Subject and methods: We analyzed the scans of 122 patients (66 patients with proven tumor). The patient population was divided into groups with Tg above (N = 33) and below (N = 33) 5 ng/ml under TSH suppression or above (N = 33) and below (N = 33) 50 ng/ml under TSH stimulation. Tumor detectability was compared by ROC-analysis (True-Positive-Fraction test, specificity 90%). Results: There was no significant difference (sensitivity 75% versus 64%; p = 0.55) for patients above and below 5 ng/ml under TSH suppression and a just significant difference (sensitivity 80% versus 58%; p = 0.04) for patients above and below 50 ng/ml under TSH stimulation. In 18 patients from our sample with tumor, Tg under TSH suppression was negative, but 201-TICI-scan was able to detect tumor in 12 patients. Conclusion: Our results demonstrate only a moderate dependence of tumor detectability on Tg level, probably without significant clinical relevance. Even in patients with slight Tg elevation 201-TICI scintigraphy is justified.

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