Data-driven Thyroglobulin Cutoffs for Low- and Intermediate-risk Thyroid Cancer Follow-up: ITCO Real-world Analysis
| Title: | Data-driven Thyroglobulin Cutoffs for Low- and Intermediate-risk Thyroid Cancer Follow-up: ITCO Real-world Analysis |
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| Authors: | Grani G.; D'Elia S.; Puxeddu E.; Morelli S.; Arvat E.; Nervo A.; Spiazzi G.; Rolli N.; Zatelli M. C.; Ambrosio M. R.; Ceresini G.; Marina M.; Mele C.; Aimaretti G.; Santaguida M. G.; Virili C.; Crescenzi A.; Palermo A.; Rossetto Giaccherino R.; Meomartino L.; Castagna M. G.; Maino F.; Trevisan M.; De Leo S.; Chiofalo M. G.; Pezzullo L.; Sparano C.; Petrone L.; Di Dalmazi G.; Napolitano G.; Tumino D.; Crocetti U.; Bertagna F.; Deandrea M.; Antonelli A.; Mian C.; Carbone A.; Monti S.; Porcelli T.; Brigante G.; Barbaro D.; Alfo M.; Ferraro Petrillo U.; Filetti S.; Durante C. |
| Contributors: | Grani, G.; D'Elia, S.; Puxeddu, E.; Morelli, S.; Arvat, E.; Nervo, A.; Spiazzi, G.; Rolli, N.; Zatelli, M. C.; Ambrosio, M. R.; Ceresini, G.; Marina, M.; Mele, C.; Aimaretti, G.; Santaguida, M. G.; Virili, C.; Crescenzi, A.; Palermo, A.; Rossetto Giaccherino, R.; Meomartino, L.; Castagna, M. G.; Maino, F.; Trevisan, M.; De Leo, S.; Chiofalo, M. G.; Pezzullo, L.; Sparano, C.; Petrone, L.; Di Dalmazi, G.; Napolitano, G.; Tumino, D.; Crocetti, U.; Bertagna, F.; Deandrea, M.; Antonelli, A.; Mian, C.; Carbone, A.; Monti, S.; Porcelli, T.; Brigante, G.; Barbaro, D.; Alfo, M.; Ferraro Petrillo, U.; Filetti, S.; Durante, C. |
| Publisher Information: | Endocrine Society |
| Publication Year: | 2025 |
| Collection: | Padua Research Archive (IRIS - Università degli Studi di Padova) |
| Subject Terms: | predictor; radioiodine; threshold; thyroglobulin; treatment response |
| Description: | Context: The utility of thyroglobulin (Tg) in the follow-up of patients with differentiated thyroid cancer has been well-documented. Although third-generation immunoassays have improved accuracy, limitations persist (interfering anti-Tg antibodies and measurement variability). Evolving treatment strategies require a reevaluation of Tg thresholds for optimal patient management. Objective: To assess the performance of serum Tg testing in 2 populations: patients receiving total thyroidectomy and radioiodine remnant ablation (RRA) or treated with thyroidectomy alone. Design: Prospective observational study. Setting: Centers contributing to the Italian Thyroid Cancer Observatory database. Patients: We included 540 patients with 5 years of follow-up and negative anti-Tg antibodies. Interventions: Serum Tg levels assessed at 1-year follow-up visit. Main Outcome Measure: Detection of structural disease within 5 years of follow-up. Results: After excluding 26 patients with structural disease detected at any time point, the median Tg did not differ between patients treated with or without radioiodine. Data-driven Tg thresholds were established based on the 97th percentile of Tg levels in disease-free individuals: 1.97 ng/mL for patients undergoing thyroidectomy alone (lower than proposed by the Memorial Sloan Kettering Cancer Center protocol and ESMO Guidelines, yet demonstrating good predictive ability, with a negative predictive value of 98% and 0.84 ng/mL for patients receiving postsurgical RRA. High sensitivity and negative predictive value supported the potential of these thresholds in excluding structural disease. Conclusion: This real-world study provides evidence for the continued reliability of 1-year serum Tg levels. The data-driven Tg thresholds proposed offer valuable insights for clinical decision-making in patients undergoing total thyroidectomy with or without RRA. |
| Document Type: | article in journal/newspaper |
| Language: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/39150986; info:eu-repo/semantics/altIdentifier/wos/WOS:001303464100001; volume:110; issue:5; firstpage:1377; lastpage:1384; numberofpages:8; journal:THE JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM; https://hdl.handle.net/11577/3560050 |
| DOI: | 10.1210/clinem/dgae559 |
| Availability: | https://hdl.handle.net/11577/3560050; https://doi.org/10.1210/clinem/dgae559 |
| Rights: | info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: | edsbas.A1E929E9 |
| Database: | BASE |