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Elevated serum thyroglobulin levels at the time of ablative radioactive iodine therapy indicate a worse prognosis in thyroid cancer: an Australian retrospective cohort study

Published online by Cambridge University Press:  04 August 2016

T J Matthews ,
E Chua ,
A Gargya ,
J Clark ,
K Gao  and
M Elliott
T J Matthews*
Affiliation:
Department of Head and Neck Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
E Chua
Affiliation:
Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia Sydney Medical School, University of Sydney, New South Wales, Australia
A Gargya
Affiliation:
Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia Sydney Medical School, University of Sydney, New South Wales, Australia
J Clark
Affiliation:
Department of Head and Neck Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia Sydney Medical School, University of Sydney, New South Wales, Australia
K Gao
Affiliation:
Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse at Royal Prince Alfred Hospital, New South Wales, Australia
M Elliott
Affiliation:
Department of Head and Neck Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia Sydney Medical School, University of Sydney, New South Wales, Australia
*
Address for correspondence: Dr Timothy James Matthews, Suite 7–155, Missenden Rd, Newtown, NSW 2042, Australia Fax: +61 2 8078 4408 E-mail: timmatthews@me.com
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Abstract

Background:

Serum thyroglobulin is used as a surrogate marker for well-differentiated thyroid carcinoma recurrence. This study investigates whether thyroglobulin measured at the time of ablative radioactive iodine therapy predicts disease-free survival.

Methods:

A retrospective review was conducted of patients with well-differentiated thyroid carcinoma presenting from 1989 to 2010 at the Royal Prince Alfred Hospital, New South Wales, Australia. Disease-free survival of patients with a significantly elevated stimulated thyroglobulin level (27.5 µg/l or higher) at the time of ablative radioactive iodine therapy was compared to that of patients without a significantly elevated thyroglobulin level using univariate analysis.

Results:

Patients with a thyroglobulin level of 27.5 µg/l or higher had an increased relative risk of disease recurrence of 4.50 (95 per cent confidence interval = 1.35–15.04). If lateral neck dissection was required at the time of surgery, patients also had an increased relative risk of macroscopic disease recurrence of 4.94 (95 per cent confidence interval = 1.47–16.55).

Conclusion:

An elevated thyroglobulin level of 27.5 µg/l or higher at the time of ablative radioactive iodine therapy is a prognostic indicator for macroscopic disease recurrence in well-differentiated thyroid carcinoma.

Keywords

ThyroglobulinPrognosisThyroid NeoplasmsIodineBiochemical Tumor MarkersDisease-Free Survival
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Supplement S4 , July 2016 , pp. S50 - S53
Copyright
Copyright © JLO (1984) Limited 2016 

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