Data-driven Thyroglobulin Cutoffs for Low- and Intermediate-risk Thyroid Cancer Follow-up: ITCO Real-world Analysis

被引:1
|
作者
Grani, Giorgio [1 ]
D'Elia, Silvia [2 ]
Puxeddu, Efisio [3 ]
Morelli, Silvia
Arvat, Emanuela [4 ]
Nervo, Alice [4 ]
Spiazzi, Giovanna [5 ]
Rolli, Nicoletta [5 ]
Zatelli, Maria Chiara [6 ]
Ambrosio, Maria Rosaria [6 ]
Ceresini, Graziano [7 ]
Marina, Michela [7 ]
Mele, Chiara [8 ]
Aimaretti, Gianluca [8 ]
Santaguida, Maria Giulia [9 ]
Virili, Camilla [9 ]
Crescenzi, Anna [10 ,11 ]
Palermo, Andrea [12 ]
Rossetto Giaccherino, Ruth [13 ]
Meomartino, Letizia [13 ]
Castagna, Maria Grazia [14 ]
Maino, Fabio [14 ]
Trevisan, Matteo [15 ]
De Leo, Simone [15 ]
Chiofalo, Maria Grazia [16 ]
Pezzullo, Luciano
Sparano, Clotilde [17 ]
Petrone, Luisa [17 ]
Di Dalmazi, Giulia [18 ]
Napolitano, Giorgio [18 ]
Tumino, Dario [19 ]
Crocetti, Umberto [20 ]
Bertagna, Francesco [21 ,22 ]
Deandrea, Maurilio [23 ]
Antonelli, Alessandro [24 ]
Mian, Caterina [25 ]
Carbone, Antonella [26 ]
Monti, Salvatore [27 ]
Porcelli, Tommaso [28 ]
Brigante, Giulia [29 ,30 ]
Barbaro, Daniele [31 ]
Alfo, Marco [2 ]
Ferraro Petrillo, Umberto [2 ]
Filetti, Sebastiano [1 ]
Durante, Cosimo [1 ]
机构
[1] Sapienza Univ Rome, Dept Translat & Precis Med, Viale Policlin 155, I-00161 Rome, Italy
[2] Sapienza Univ Rome, Dept Stat Sci, I-00185 Rome, Italy
[3] Univ Perugia, Dept Med & Surg, I-06129 Perugia, Italy
[4] Univ Turin, Citta Salute & Sci Hosp, Dept Med Sci, Oncol Endocrinol Unit, I-10126 Turin, Italy
[5] Azienda Osped Univ Verona, Dept Med, Endocrinol & Diabetol Unit, I-37126 Verona, Italy
[6] Univ Ferrara, Dept Med Sci, Sect Endocrinol Geriatr & Internal Med, I-44121 Ferrara, Italy
[7] Univ Hosp Parma, Unit Internal Med & Oncol Endocrinol, I-43126 Parma, Italy
[8] Univ Piemonte Orientale, Dept Translat Med, Endocrinol, I-28100 Novara, Italy
[9] Sapienza Univ Rome, Dept Med Surg Sci & Biotechnol, Endocrinol Unit, I-04100 Latina, Italy
[10] Sapienza Univ Rome, Dept Radiol Oncol & Pathol Sci, I-00161 Rome, Italy
[11] Fdn Policlin Univ Campus Biomed, Unit Endocrine Organs & Neuromuscolar Pathol, I-00128 Rome, Italy
[12] Fdn Policlin Univ Campus Biomed, Unit Metab Bone & Thyroid Dis, Rome, Italy
[13] Univ Turin, Dept Med Sci, Endocrinol Diabetol & Metab, I-10126 Turin, Italy
[14] Univ Siena, Dept Med Surg & Neurosci, Sect Endocrinol, I-53100 Siena, Italy
[15] IRCCS Ist Auxol Italiano, Dept Endocrine & Metab Dis, Endocrine Oncol Unit, I-20095 Milan, Italy
[16] NCI, IRCCS Fdn G Pascale, I-80131 Naples, Italy
[17] Univ Florence, Dept Expt & Clin Biomed Sci Mario Serio, Endocrinol Unit, I-50134 Florence, Italy
[18] Univ G Annunzio Chieti Pescara, Dept Med & Aging Sci, I-66100 Chieti, Italy
[19] Univ Catania, Dept Clin & Expt Med, I-95122 Catania, Italy
[20] IRCCS, Dept Med Sci, Hosp Casa Sollievo Sofferenza, I-71013 San Giovanni Rotondo, Italy
[21] Univ Brescia, Dept Med & Surg Specialties, Nucl Med, Radiol Sci, I-25123 Brescia, Italy
[22] Spedali Civili Brescia, I-25123 Brescia, Italy
[23] AO Ordine Mauriziano Torino, UO Endocrinol Diabetol & Malattie Metab, I-10128 Turin, Italy
[24] Univ Pisa, Dept Surg Med & Mol Pathol & Crit Area, I-56100 Pisa, Italy
[25] DIMED Univ Padua, Dept Med, Operat Unit Endocrinol, I-35128 Padua, Italy
[26] Tinchi Hosp, Endocrine Unit, Matera, Italy
[27] Sapienza Univ Rome, Endocrinol & Diabet Unit, Azienda Osped Univ Sant Andrea, I-00189 Rome, Italy
[28] Univ Naples Federico II, Dept Publ Hlth, I-80131 Naples, Italy
[29] Univ Modena & Reggio Emilia, Dept Biomed Metab & Neural Sci, Unit Endocrinol, I-41125 Modena, Italy
[30] Azienda Osped Univ Modena, Dept Med Specialties, Unit Endocrinol, I-41124 Modena, Italy
[31] Unit Endocrinol ASL North West Tuscany, Ospedali Riuniti, I-57124 Livorno, Italy
来源
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM | 2024年
关键词
thyroglobulin; threshold; predictor; treatment response; radioiodine; RADIOIODINE REMNANT ABLATION; SERUM THYROGLOBULIN; RADIOACTIVE IODINE; CLINICAL-PRACTICE; SELECTIVE USE; PAPILLARY; AUTOANTIBODY; GUIDELINES; MANAGEMENT; ASSAYS;
D O I
10.1210/clinem/dgae559
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Context The utility of thyroglobulin (Tg) in the follow-up of patients with differentiated thyroid cancer has been well-documented. Although third-generation immunoassays have improved accuracy, limitations persist (interfering anti-Tg antibodies and measurement variability). Evolving treatment strategies require a reevaluation of Tg thresholds for optimal patient management.Objective To assess the performance of serum Tg testing in 2 populations: patients receiving total thyroidectomy and radioiodine remnant ablation (RRA) or treated with thyroidectomy alone.Design Prospective observational study.Setting Centers contributing to the Italian Thyroid Cancer Observatory database.Patients We included 540 patients with 5 years of follow-up and negative anti-Tg antibodies.Interventions Serum Tg levels assessed at 1-year follow-up visit.Main Outcome Measure Detection of structural disease within 5 years of follow-up.Results After excluding 26 patients with structural disease detected at any time point, the median Tg did not differ between patients treated with or without radioiodine. Data-driven Tg thresholds were established based on the 97th percentile of Tg levels in disease-free individuals: 1.97 ng/mL for patients undergoing thyroidectomy alone (lower than proposed by the Memorial Sloan Kettering Cancer Center protocol and ESMO Guidelines, yet demonstrating good predictive ability, with a negative predictive value of 98% and 0.84 ng/mL for patients receiving postsurgical RRA. High sensitivity and negative predictive value supported the potential of these thresholds in excluding structural disease.Conclusion This real-world study provides evidence for the continued reliability of 1-year serum Tg levels. The data-driven Tg thresholds proposed offer valuable insights for clinical decision-making in patients undergoing total thyroidectomy with or without RRA.
引用
收藏
页数:8
相关论文
共 47 条
  • [1] The role of neck ultrasound in the follow-up of low- and intermediate-risk papillary thyroid cancer
    Lopes, Sara Gomes de Campos
    Ferreira, David Nuno Dias Silva
    Fernandes, Vera Adriana Ribeiro
    Marques, Helena Manuela da Costa Cardoso
    Pereira, Ricardo Fernando da Silva Santos
    Monteiro, Ana Margarida Carvalho
    ARCHIVES OF ENDOCRINOLOGY METABOLISM, 2022, 66 (04): : 481 - 488
  • [2] The diagnostic value of stimulated serum thyroglobulin in the follow-up of low and intermediate-risk patients with differentiated thyroid cancer
    Mihaljevic, I.
    Wagenhofer, V.
    Kralj, T.
    Vrdoljak, D.
    Kizivat, T.
    Mudri, D.
    Franceschi, M.
    Jukic, T.
    EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2020, 47 (SUPPL 1) : S699 - S700
  • [3] Sufficiency of a Single Negative Thyroglobulin Standard for Judging the Success of Ablation in Low- and Intermediate-risk Differentiated Thyroid Cancer: A Retrospective Study
    Long, Yahong
    Jin, Jianhua
    Zhang, Wanchun
    ENDOCRINE METABOLIC & IMMUNE DISORDERS-DRUG TARGETS, 2024, 24 (10) : 1204 - 1214
  • [4] 125Iodine monotherapy for Japanese men with low- and intermediate-risk prostate cancer: outcomes after 5 years of follow-up
    Sekiguchi, Akane
    Ishiyama, Hiromichi
    Satoh, Takefumi
    Tabata, Kenichi
    Komori, Shouko
    Tsumura, Hideyasu
    Kawakami, Shogo
    Soda, Itaru
    Iwamura, Masatsugu
    Hayakawa, Kazushige
    JOURNAL OF RADIATION RESEARCH, 2014, 55 (02) : 328 - 333
  • [5] Undetectable thyroglobulin after total thyroidectomy in patients with low- and intermediate-risk papillary thyroid cancer- is there a need for radioactive iodine therapy?
    Ibrahimpasic, Tihana
    Nixon, Iain J.
    Palmer, Frank L.
    Whitcher, Monica M.
    Tuttle, Robert M.
    Shaha, Ashok
    Patel, Snehal G.
    Shah, Jatin P.
    Ganly, Ian
    SURGERY, 2012, 152 (06) : 1096 - 1104
  • [6] Efficacy of Low-Dose Radioiodine Ablation in Low- and Intermediate-Risk Differentiated Thyroid Cancer: A Retrospective Comparative Analysis
    Maria Gomez-Perez, Ana
    Garcia-Aleman, Jorge
    Molina-Vega, Maria
    Sebastian Ochoa, Arantzazu
    Perez Garcia, Pilar
    Mancha Doblas, Isabel
    Tinahones, Francisco J.
    JOURNAL OF CLINICAL MEDICINE, 2020, 9 (02)
  • [7] Undetectable thyroglobulin after total thyroidectomy in patients with low- and intermediate-risk papillary thyroid cancer- is there a need for radioactive iodine therapy? DISCUSSION
    Rosen, Irving B.
    Shaha, Ashok
    Snyder, Samuel
    Ibrahimpasic, Tihana
    Harari, Avital
    Carter, Bradford
    SURGERY, 2012, 152 (06) : 1104 - 1105
  • [8] The Diagnostic Value of Stimulated Serum Thyroglobulin in the Follow-up of Low-Risk Patients with Differentiated Thyroid Cancer
    Wagenhofer, V.
    Mihaljevic, I.
    Kralj, T.
    Snajder, D.
    EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2012, 39 : S563 - S564
  • [9] Thyroglobulin levels after recombinant TSH in the follow-up of low-risk patients with differentiated thyroid cancer
    Vlassopoulou, V
    Vassilatou, E
    Botoula, E
    Gripeou, C
    Christoforaki, M
    Tzavara, I
    Thalassinos, N
    PROCEEDINGS OF THE 12TH INTERNATIONAL CONGRESS OF ENDOCRINOLOGY, 2004, : 1087 - 1090
  • [10] 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
    Steven Orlov
    Farnaz Salari
    Lawrence Kashat
    Jeremy L. Freeman
    Allan Vescan
    Ian J. Witterick
    Paul G. Walfish
    Endocrine, 2015, 50 : 130 - 137