Prognostic Impact of Serum Thyroglobulin Doubling-Time Under Thyrotropin Suppression in Patients with Papillary Thyroid Carcinoma Who Underwent Total Thyroidectomy

Miyauchi, Akira; Kudo, Takumi; Miya, Akihiro; Kobayashi, Kaoru; Ito, Yasuhiro; Takamura, Yuuki; Higashiyama, Takuya; Fukushima, Mitsuhiro; Kihara, Minoru; Inoue, Hiroyuki; Tomoda, Chisato; Yabuta, Tetsuro; Masuoka, Hiroo

doi:10.1089/thy.2010.0355

Cited by 226 publications

(178 citation statements)

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“…• Tg-doubling time (Tg-DT): for the irst time in 2011, Tg-doubling time was proposed as a dynamic prognostic factor [44]. Tg-DT was recognized as an independent prognostic factor for both DFS and CSS of patients, whereas a short Tg-DT time (less than 1 year) is an indicator of poor prognosis.…”

Section: Categories Of Thyroid Malignanciesmentioning

confidence: 99%

“…Poorly diferentiated papillary thyroid carcinoma has been discussed as a separate section. Dynamic prognostic factors are based on changes in serum thyroglobulin (Tg) and thyroglobulin antibody (TgAb) after total thyroidectomy, which help with estimation of recurrence and cause-speciic survival (CSS) of PTC patients.• Tg-doubling time (Tg-DT): for the irst time in 2011, Tg-doubling time was proposed as a dynamic prognostic factor [44]. Tg-DT was recognized as an independent prognostic factor for both DFS and CSS of patients, whereas a short Tg-DT time (less than 1 year) is an indicator of poor prognosis.…”

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confidence: 99%

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Thyroid Cancers: Considerations, Classifications, and Managements

Khosravi¹,

Kouhi²,

Saeedi³

et al. 2017

Diagnosis and Management of Head and Neck Cancer

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Rapidly increasing trend of thyroid cancer incidence has turned this disease into a global concern. An estimated number of 64,300 new cases of thyroid cancer occurred in men and women in 2016, which represents 3.8% of all new cancer cases of USA (htps://seer. cancer.gov/statfacts/html/thyro.html). Thus, there is a high possibility for every physician to encounter a case of thyroid cancer during his/her professional lifetime. In this chapter, we clariied epidemiology, diferent categories, and new approaches toward diagnosis and management of thyroid cancer.Keywords: thyroid cancer, epidemiology, diferentiated thyroid cancer, undiferentiated thyroid cancer, thyroid nodule Detailed epidemiology of thyroid cancerAs the most common endocrine cancer and ifth most common cancer in women, thyroid cancer includes approximately 1-1.5% of all new cases of cancer diagnosed annually in the USA based on previous data [1][2][3]. Thyroid cancer is more prevalent among women and those with positive family history of thyroid disease. Some prior studies have reported a worldwide increasing trend for thyroid cancer incidence in recent decades [4]. Annual percent change (APC) is a commonly used indicator for the assessment of changes in incidence. Based on US National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program, it has been reported 2.4% from 1980 to 1997 and 6.6% from 1997 to 2009 in both genders for thyroid cancer (data available at htp://seer.cancer.gov/statfacts/html/thyro.html).© 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.According to [2009][2010][2011][2012][2013] data, the rate of new cases of thyroid cancer was 13.9 per 100,000 men and women per year (Figure 1). Table 1 summarizes number of new cases per 100,000 persons by race/ethnicity and sex. A recently published study on adolescent cancer incidence during 1975-2012 has reported a 2.12% increase for females and 1.59% for males between 15 and 19 years of age [5]. However, there is a study indicating that thyroid cancer incidence trend has slowed following release of American Thyroid Association (ATA) guideline in 2009 [6, 7]. It has been reported that overall thyroid cancer incidence had an increasing trend about 8% per year from 2000 to 2009. But APC showed a deceleration about 3% in men and 2.8% in women, which was conined to tumors less than 2.9 cm of size for women [7].Also, thyroid cancer-related mortality was estimated to consist 0.3% of all cancer-related deaths in 2016. A 5-year survival rate of 98.1% has been reported for thyroid cancer. Despite increasing trend of incidence, thyroid cancer mortality has a relatively stable rate about 0.5 cases per 100,000 persons both from 1973 to 2002 and 2009 to 2013 [8, 9].In conclusion, it seems that thyroid cancer has been following an ...

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Section: Categories Of Thyroid Malignanciesmentioning

confidence: 99%

mentioning

confidence: 99%

Thyroid Cancers: Considerations, Classifications, and Managements

Khosravi¹,

Kouhi²,

Saeedi³

et al. 2017

Diagnosis and Management of Head and Neck Cancer

View full text Add to dashboard Cite

show abstract

“…In addition, the trend in basal hsTg, measured when TSH is lowered/suppressed at constant level, should reflect changes in thyroid tissue mass and thus provide a sensitive parameter for disease [19,24,61,65]. This is also supported by a growing number of studies showing the prognostic utility of monitoring the basal hsTg trend and Tg doubling time [66][67][68][69]. A further limitation to the available evidence is that most patients who were enrolled in the studies were affected by low-risk DTC.…”

Section: Clinical Impact Of New Highly Sensitive Tg Assaysmentioning

confidence: 99%

Thyroglobulin measurement by highly sensitive assays: focus on laboratory challenges

Giovanella

Feldt‐Rasmussen

Verburg

et al. 2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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Differentiated thyroid cancer (DTC) is the most common endocrine cancer and its incidence has increased in recent decades. The initial treatment consists of total thyroidectomy followed by ablation of thyroid remnants by radioiodine in most cases. As thyroid cells are the only source of thyroglobulin (Tg), circulating Tg serves as a biochemical marker of persistent or recurrent disease in the follow-up of DTC. Due to the suboptimal clinical detection rate of older Tg assays endogenous or exogenous thyrotropin (TSH) stimulations are recommended for unmasking occult disease. However, the development of new Tg assays with improved analytical sensitivity and precision at low concentrations now allows detection of very low Tg concentrations, reflecting minimal amounts of thyroid tissue, even without the need for TSH stimulation. Even if the use of these assays still has not found its way in current clinical guidelines, such assays are now increasingly used in clinical practice. As serum Tg measurement is a technically challenging assay and criteria to define a 'highly sensitive' assay may be different, a good knowledge of the technical difficulties and interpretation criteria is of paramount importance for both clinical thyroidologists, laboratory physicians and scientists involved in the care of DTC patients.

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“…Miyauchi et al studied serum Tg kinetics in patients under thyrotropin suppression and demonstrated than Tg-DT less than 1 year under thyrotropin suppression is a very strong predictor of locoregional recurrence [16,17]. Giovanella et al also reviewed Tg-DT under thyrotropin suppression and demonstrated that patients having Tg-DT less than 1 year under thyrotropin suppression significantly improves that chance of positive findings on F-18 FDG PET/CT [10].…”

Section: Resultsmentioning

confidence: 99%

Correlation of Consecutive Serum Thyroglobulin Levels During Hormone Withdrawal and Failure of Initial Radioiodine Ablation in Thyroid Cancer Patients

Yoon

Kim

et al. 2015

Nucl Med Mol Imaging

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Objective The aim of this study was to evaluate the value of thyroglobulin (Tg) kinetics during preparation of radioiodine ablation for prediction of initial radioiodine ablation failure in thyroid cancer patients. Methods Thyroid cancer patients after total thyroidectomy who underwent radioiodine ablation with 3-4 weeks of hormone withdrawal between May 2011 and January 2012 were included. Consecutive serum Tg levels 5-10 days before ablation (Tg1) and on the day of ablation (Tg2) were obtained. The difference between Tg1 and Tg2 (ΔTg), daily change rate of Tg (ΔTg/day) and Tg doubling time (Tg-DT) were calculated. Success of initial ablation was determined by the results of the follow-up ultrasonography, diagnostic radioiodine scan and stimulated Tg level after 6 to 20 months. Results A total of 143 patients were included. Failed ablation was reported in 52 patients. Tg2 higher than 5.6 ng/ml and Tg-DT shorter than 4.2 days were significantly related to a high risk of ablation failure. ΔTg and ΔTg/day did not show significant correlation with ablation failure. Conclusions Thyroglobulin kinetics on consecutive blood sampling during hormone withdrawal may be helpful in predicting patients with higher risk of treatment failure of initial radioiodine ablation therapy in thyroid cancer patients.

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Prognostic Impact of Serum Thyroglobulin Doubling-Time Under Thyrotropin Suppression in Patients with Papillary Thyroid Carcinoma Who Underwent Total Thyroidectomy

Abstract: Tg-DT (all data or first four data) is a very strong prognostic predictor superior to the classical prognostic factors in patients with PTC.

Cited by 226 publications

References 18 publications

Thyroid Cancers: Considerations, Classifications, and Managements

Thyroid Cancers: Considerations, Classifications, and Managements

Thyroglobulin measurement by highly sensitive assays: focus on laboratory challenges

Correlation of Consecutive Serum Thyroglobulin Levels During Hormone Withdrawal and Failure of Initial Radioiodine Ablation in Thyroid Cancer Patients

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