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Post-ablative serum thyroglobulin is an independent predictor of recurrence in low-risk differentiated thyroid
Hanna Pelttari1, Matti J Välimäki, Eliisa Löyttyniemi
1Division of Endocrinology, Department of Medicine, Helsinki University Central Hospital, PO Box 340, FI-00290 Helsinki, Finland. hanna.pelttari@kolumbus.fi
Objective:
To study whether post-surgical and/or post-ablative thyroglobulin (Tg) concentrations may serve as independent predictors of disease recurrence in patients treated for TNM stage I or II well-differentiated thyroid carcinoma (WDTC).
Design:
An observational retrospective study with a median follow-up of 16 years (range 10-24).
Patients And Measurements:
Post-operative and post-ablative Tg concentrations, age, tumour size, local infiltration and nodal metastasis at primary surgery as well as disease recurrences and cancer-specific deaths were evaluated in 495 low-risk (TNM stages I and II) patients, the majority of whom had total thyroidectomy and radioactive iodine remnant ablation as initial treatment.
Results:
Fifty-one patients (10.3%) experienced disease recurrence during follow-up. In multiple logistic regression analysis, post-ablative Tg concentrations (odds ratio (OR) 3.72, confidence interval (CI) 1.71-8.05, P=0.0009) and local infiltration on primary surgery (OR 2.66, CI 1.03-6.90, P=0.04) were the only independent predictors of recurrence.
Conclusions:
Post-ablative Tg concentration is a strong predictor of disease recurrence in WDTC.
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