Pre-operative thyroglobulin measurement for thyroid cancer risk of recurrence and response to therapy

Thyroid cancer has an overall favorable prognosis, but no pre-operative biochemical marker has been shown to distinguish between low and high-risk disease or predict response to therapy. We retrospectively reviewed 162 patients that underwent thyroid surgery for thyroid cancer between 2006 and 2022...

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Bibliographic Details
Published inThe American journal of surgery p. 115818
Main Authors Barrio, Martin Jose, Pozdeyev, Nikita, Raeburn, Christopher D., McIntyre, Robert C., Marshall, Carrie B., Haugen, Bryan, La Greca, Amanda
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 03.07.2024
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Summary:Thyroid cancer has an overall favorable prognosis, but no pre-operative biochemical marker has been shown to distinguish between low and high-risk disease or predict response to therapy. We retrospectively reviewed 162 patients that underwent thyroid surgery for thyroid cancer between 2006 and 2022 in whom a pre-operative thyroglobulin level (Tg) was measured. We subdivided patients into low, intermediate and high-risk thyroid cancer and based on their response to therapy per ATA guidelines. We showed that as pre-operative Tg level increased, patients were more likely to have high-risk disease (p ​< ​0.01). We found a linear association between the primary tumor size and high-risk histology with pre-operative Tg (p ​< ​0.01). Pre-operative Tg level was significantly associated with response to therapy following initial surgical management. Specifically, as pre-operative Tg increases, patients were less likely to achieve an excellent response (p ​< ​0.01). Our retrospective analysis demonstrated that pre-operative Tg is significantly associated with ATA structural risk of recurrence and response to therapy and may have the potential to guide initial therapy and follow-up management. •Pre-operative Tg is independently associated with tumor size and aggressive histology•The lower the pre-operative Tg, the more likely the patient will have an excellent response to therapy following initial surgical management•Specifically, a low pre-operative Tg, age, and number of metastatic lymph nodes were independently associated with an excellent response to therapy•In addition, a cut off Tg value of 27.0 ​ng/ml predicted patients with high-risk disease would have an excellent response to therapy
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ISSN:0002-9610
1879-1883
1879-1883
DOI:10.1016/j.amjsurg.2024.115818