Prognostic factors for postoperative papillary thyroid cancer with unexplained elevated Tg: A retrospective study
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View abstract on PubMed
Summary
This summary is machine-generated.Elevated thyroglobulin in papillary thyroid cancer patients post-treatment is often due to biochemical disease, but structural disease develops in over 30% within five years. Advanced N and TNM stages predict recurrence-free survival.
Area Of Science
- Endocrinology
- Oncology
- Nuclear Medicine
Background
- Elevated thyroglobulin (Tg) in postoperative papillary thyroid cancer (PTC) patients after radioactive iodine ablation (RAT) without evident disease requires investigation.
- Understanding the causes and long-term outcomes is crucial for managing these patients.
Purpose Of The Study
- To determine the reasons for unexplained elevated Tg in postoperative PTC patients after RAT.
- To explore long-term clinical outcomes and identify prognostic factors for recurrence-free survival (RFS).
Main Methods
- Retrospective study of 165 postoperative PTC patients with preablative stimulated thyroglobulin (psTg) > 10 ng/mL and no structural disease.
- Analysis of Tg causes at 6 months post-RAT and long-term therapeutic responses.
- Univariate and multivariate Cox regression and Kaplan-Meier analysis for RFS risk factors.
Main Results
- At 6 months post-RAT, elevated Tg was attributed to thyroid remnant (13.94%), biochemical disease (60.00%), and structural disease (26.06%).
- Over a median follow-up of 58 months, 30.91% achieved excellent response (ER), 20.60% indeterminate (IDR), 12.73% biochemical incomplete (BIR), and 35.76% structural incomplete response (SIR).
- N1b stage and TNM stage II/III were independent risk factors for RFS (P < 0.003).
Conclusions
- Over 30% of postoperative PTC patients with unexplained elevated Tg developed structural disease within five years.
- Patients with N1b stage and higher TNM stages face increased risk of developing structural disease.
- N1b and TNM stage II/III are significant predictors of poor RFS in these patients.
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