Commentary: Application of post-surgical stimulated thyroglobulin for radioiodine remnant ablation selection in low-risk papillary thyroid carcinoma

✍ Scribed by David J. Terris

• Publisher: John Wiley and Sons
• Year: 2010
• Tongue: English
• Weight: 144 KB
• Volume: 32
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/hed.21375

✦ Synopsis

Background. We present our ongoing experience in the use of postsurgical stimulated serum thyroglobulin (Stim-Tg) to assist in radioiodine remnant ablation (RRA) decision-making.

Methods. Patients with low-risk well-differentiated thyroid carcinoma (WDTC) with undetectable anti-Tg antibodies were prospectively followed after total thyroidectomy and therapeutic central compartment neck dissection, when indicated. Stim-Tg was performed 3 months postoperatively and used to base RRA selection.

Results. Of 104 patients, 59 patients (56.7%) had an undetectable Stim-Tg after thyroidectomy, 35 (33.7%) had Stim-Tg values of 1-5 lg/L, and 10 (9.6%) had Stim-Tg values >5 lg/ L. RRA was administered to 1 patient (1.7%) with undetectable Stim-Tg, 6 patients (17.1%) with Stim-Tg1-5 lg/L, and 9 patients (90%) with Stim-Tg >5 lg/L, for a total of 16 patients (15.4%) receiving RRA. When compared to current RRA selection guidelines, the proposed protocol achieved a significantly lower RRA administration rate.

Conclusion. Stim-Tg measurement performed several months after total thyroidectomy is a useful objective parameter in assisting RRA decision-making for patients with low-risk WDTC. V