High-sensitive basal serum thyroglobulin 6–12 months after thyroid ablation is strongly associated with early response to therapy and event-free survival in patients with low-to-intermediate risk differentiated thyroid carcinomas

Abstract

Patients with low- and intermediate-risk DTC could be considered cured when they have onT4-Tg levels <0.28 ng/mL coupled with negative imaging at their first post-ablation visit.

Dynamic risk assessment in patients with differentiated thyroid cancer

“…In patients with intermediate RR, on the other hand, an excellent response implies a substantial reduction of the probability of a structural incomplete response compared to that expected from their initial RR: from 36-43% to 1-2% (Tuttle et al 2010, Castagna et al 2011, Vaisman et al 2012, Pitoia et al 2013. Another study (Trimboli et al 2017) showed that the optimized threshold of baseline Tg (on T4-Tg) measured 6-12 months after initial treatment in patients with low (Grani et al 2019). These data support the idea that low-and intermediate-risk PTC patients with an excellent response can be safely followed with clinical assessments and unstimulated serum Tg determinations with no need of routine neck ultrasonography assessment.…”

“…Considering the initial response to treatment, a patient who achieves an excellent response will have a very low risk of having structural disease (1-4%) in the long-term follow-up (Tuttle et al 2010, Castagna et al 2011, Durante et al 2012, Hong et al 2014, Pitoia et al 2015, Haugen et al 2016, Kowalska et al 2016, Trimboli et al 2017, Schlumberger et al 2018, Dehbi et al 2019. On the contrary, 50-85% of patients with an initial structural incomplete response, and probably independently of the initial RR, will have persistent disease, despite additional treatments (Tuttle et al 2010, Castagna et al 2011, Hong et al 2014, Pitoia et al 2015, Haugen et al 2016, Kowalska et al 2016, Trimboli et al 2017, Schlumberger et al 2018, Dehbi et al 2019.…”

Role of serum cytokeratin 19 fragment (Cyfra 21.1) as a prognostic biomarker in patients with differentiated thyroid cancer

“…Patients were classified as alive with no evidence of disease (NED) if there was no clinical, imaging, or cytological/histological evidence of disease and their measured basal Tg levels were undetectable (i.e. below the functional sensitivity of the locally employed assay) or, if detectable, they were less than 1 ng/mL and decreased or remained unchanged over time 30 . Patients who did not fulfill these criteria were classified as alive with disease (i.e.…”

Multicentre clinical evaluation of the new highly sensitive Elecsys® thyroglobulin II assay in patients with differentiated thyroid carcinoma

“…3,4 Nowadays, highly sensitive assays (ie functional sensitivity [FS] ~0.1-0.2 μg/L) prompt monitoring Tg without any TSH stimulation, saving economic resources and ameliorating patients' comfort. [6][7][8][9][10][11][12][13] Recent clinical guidelines define an excellent response to treatment when negative imaging and high-sensitive Tg levels <0.1-0.2 μg/L are obtained 6-12 months after primary treatment. 2 Notably, the majority of literature data were obtained by using the Tg Access ® assay (Beckman Coulter, Fullerton, CA, USA).…”