Predictors of recurrence after total thyroidectomy in 1,611 patients with papillary thyroid carcinoma: postoperative stimulated serum thyroglobulin and ATA initial and dynamic risk assessment
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View abstract on PubMed
Summary
This summary is machine-generated.Combining initial American Thyroid Association (ATA) risk stratification with postoperative stimulated thyroglobulin (s-Tg) levels improves prediction of papillary thyroid carcinoma (PTC) recurrence. Dynamic risk assessment further refines these predictions for better patient follow-up.
Area Of Science
- Endocrinology
- Oncology
- Medical Diagnostics
Background
- Papillary thyroid carcinoma (PTC) recurrence can occur despite a favorable prognosis.
- Accurate prediction of recurrence is crucial for guiding patient management and follow-up strategies.
Purpose Of The Study
- To evaluate the combined predictive value of the American Thyroid Association (ATA) risk stratification and postoperative serum thyroglobulin (s-Tg) levels for PTC recurrence.
- To compare this combined approach with dynamic risk stratification based on response to initial therapy.
Main Methods
- Retrospective analysis of 1,611 patients with PTC who underwent total thyroidectomy and radioactive iodine (RAI) therapy.
- Stratification of patients based on ATA risk categories.
- Measurement of postoperative s-Tg levels at 3 months and assessment of response to therapy using imaging and nonstimulated thyroglobulin levels.
Main Results
- Recurrence was diagnosed in 6.1% of patients over a mean follow-up of 61.5 months.
- Recurrence rates increased with ATA risk: 2.3% (low), 9% (intermediate), 25% (high).
- A postoperative s-Tg cutoff of 10 ng/mL showed high negative predictive value (97.8%) for recurrence. Combining ATA risk and s-Tg improved recurrence prediction (12.7% to 29.9%), with dynamic risk stratification reaching 49.1%.
Conclusions
- The combination of ATA staging and postoperative s-Tg levels offers improved prediction of PTC recurrence.
- Dynamic risk assessment based on treatment response further refines initial risk estimates.
- These refined predictions can guide personalized follow-up recommendations for PTC patients.
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