Stimulated Thyroglobulin and Thyroglobulin Reduction Index Predict Excellent Response in Differentiated Thyroid Cancers

Abstract Context Despite its good prognosis, differentiated thyroid cancer (DTC) is characterized by high rates of disease persistence and recurrence. Estimation of long-term remission (excellent response) thanks to specific parameters could help to individualize the active surveillance schedule. Ob...

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Published in:The journal of clinical endocrinology and metabolism 2019-08, Vol.104 (8), p.3462-3472
Main Authors: Barres, Bertrand, Kelly, Antony, Kwiatkowski, Fabrice, Batisse-Lignier, Marie, Fouilhoux, Geneviève, Aubert, Bernadette, Dutheil, Frédéric, Tauveron, Igor, Cachin, Florent, Maqdasy, Salwan
Format: Article
Language:English
Subjects:
Adult
Antineoplastic Protocols
Cancer
Combined Modality Therapy
Diseases
Female
Humans
Iodine
Iodine Radioisotopes
Life Sciences
Lymph nodes
Male
Medical prognosis
Medical research
Medicine, Experimental
Middle Aged
Predictive Value of Tests
Prognosis
Radiofrequency Ablation
Relapse
Remission
Remission Induction
Retrospective Studies
Thyroglobulin
Thyroglobulin - blood
Thyroid cancer
Thyroid gland
Thyroid Hormones - blood
Thyroid Neoplasms - blood
Thyroid Neoplasms - therapy
Thyroid-stimulating hormone
Thyroidectomy
Thyroxine
Treatment Outcome
Triiodothyronine
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Summary:Abstract Context Despite its good prognosis, differentiated thyroid cancer (DTC) is characterized by high rates of disease persistence and recurrence. Estimation of long-term remission (excellent response) thanks to specific parameters could help to individualize the active surveillance schedule. Objective Evaluation of the ability of stimulated thyroglobulin (Tg) and Tg reduction index (TRI) to predict long-term remission in patients with DTC managed by thyroidectomy and radioactive iodine (RAI) remnant ablation. Patients and Interventions Observational retrospective study of 1093 patients treated for DTC between 1995 and 2010. Preablation stimulated thyroglobulin (presTg) was measured under thyroid hormone withdrawal just before RAI. Recombinant human TSH–stimulated thyroglobulin (sTg) was measured at first evaluation of the initial management 6 to 12 months after RAI. TRI was calculated based on pre-Tg and sTg. Results After univariate and multivariate analyses, lymph node invasion (N1, OR = 2.08; 95% CI, 1.19 to 3.64), presTg (OR = 4.04; 95% CI, 2.56 to 6.38), sTg (OR = 2.62; 95% CI, 2.05 to 3.34), and TRI (OR = 0.43; 95% CI, 0.21 to 0.88) were identified as independent prognostic factors influencing the rate of disease persistence or recurrence after the initial management. Receiver operating characteristic analysis identified presTg cutoff (
ISSN:0021-972X
1945-7197
DOI:10.1210/jc.2018-02680