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Web End = Ann Surg Oncol (2015) 22:41934197 DOI 10.1245/s10434-015-4567-3
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Web End = ORIGINAL ARTICLE ENDOCRINE TUMORS
Undetectable Thyroglobulin Levels in Poorly Differentiated Thyroid Carcinoma Patients Free of Macroscopic Disease After Initial Treatment: Are They Useful?
Tihana Ibrahimpasic, MD1, Ronald Ghossein, MD2, Diane L. Carlson, MD3, Iain J. Nixon, MD1, Frank L. Palmer, BA1, Snehal G. Patel, MD1, Robert M. Tuttle, MD4, Ashok Shaha, MD1, Jatin P. Shah, MD1, and Ian Ganly, MD, PhD1
1Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; 2Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY; 3Department of Pathology, Cleveland Clinic, Weston, FL; 4Department of Endocrinology, Memorial Sloan Kettering Cancer Center, New York, NY
ABSTRACTBackground. Predictive role of undetectable thyroglobulin (Tg) in patients with poorly differentiated thyroid carcinoma (PDTC) is unclear. Our goal was to report on Tg levels following total thyroidectomy and adjuvant RAI in PDTC patients and to correlate Tg levels with recurrence.
Methods. Forty patients with PDTC with no distant metastases at presentation (M0) and managed by total thyroidectomy and adjuvant RAI were identied from a database of 91 PDTC patients. Of these, 31 patients had Tg values recorded and formed the basis of our analysis. A nonstimulated Tg level\1 ng/ml was used as a cutoff point for undetectable Tg levels. Association of patient and tumor characteristics with Tg levels was examined by v2 test.
Recurrence-free survival (RFS) stratied by postop Tg level was calculated by KaplanMeier method and compared by log-rank test.
Results. Twenty patients had undetectable Tg (\1 ng/ml)
and 11 had detectable Tg (C1 ng/ml; range 2129 ng/ml) following surgery. After adjuvant RAI, 24 patients had undetectable Tg (\1 ng/ml) and 7 had detectable Tg (C1 ng/ml; range 157 ng/ml). Patients with undetectable
Tg were less likely to have pathologically positive margins compared to those with detectable Tg (33 vs. 72 % respectively; p = 0.03). Patients with undetectable Tg levels had better 5-year regional control and distant control than patients with detectable Tg level (5-year regional recurrence-free survival 96 vs. 69...