scholarly journals Positive Predictive Value of Serum Thyroglobulin Levels, Measured during the First Year of Follow-Up after Thyroid Hormone Withdrawal, in Thyroid Cancer Patients

2003 ◽  
Vol 88 (3) ◽  
pp. 1107-1111 ◽  
Author(s):  
E. Baudin ◽  
C. Do Cao ◽  
A. F. Cailleux ◽  
S. Leboulleux ◽  
J. P. Travagli ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Positive Predictive Value ◽  
Cancer Patients ◽  
Predictive Value ◽  
First Year ◽  
Serum Thyroglobulin ◽  
Thyroid Hormone Withdrawal

scholarly journals A Consensus Report of the Role of Serum Thyroglobulin as a Monitoring Method for Low-Risk Patients with Papillary Thyroid Carcinoma

2003 ◽  
Vol 88 (4) ◽  
pp. 1433-1441 ◽  
Author(s):  
E. L. Mazzaferri ◽  
R. J. Robbins ◽  
C. A. Spencer ◽  
L. E. Braverman ◽  
F. Pacini ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Clinical Evidence ◽  
Low Risk ◽  
Whole Body ◽  
Serum Thyroglobulin ◽  
Thyroid Hormone Withdrawal ◽  
Body Scanning ◽  
Risk Patients

Recent studies have provided new information regarding the optimal surveillance protocols for low-risk patients with differentiated thyroid cancer (DTC). This article summarizes the main issues brought out in a consensus conference of thyroid cancer specialists who analyzed and discussed this new data. There is growing recognition of the value of serum thyroglobulin (Tg) as part of routine surveillance. An undetectable serum Tg measured during thyroid hormone suppression of TSH (THST) is often misleading. Eight studies show that 21% of 784 patients who had no clinical evidence of tumor with baseline serum Tg levels usually below 1 μg/liter during THST had, in response to recombinant human TSH (rhTSH), a rise in serum Tg to more than 2 μg/liter. When this happened, 36% of the patients were found to have metastases (36% at distant sites) that were identified in 91% by an rhTSH-stimulated Tg above 2 μg/liter. Diagnostic whole body scanning, after either rhTSH or thyroid hormone withdrawal, identified only 19% of the cases of metastases. Ten studies comprising 1599 patients demonstrate that a TSH-stimulated Tg test using a Tg cutoff of 2 μg/liter (either after thyroid hormone withdrawal or 72 h after rhTSH) is sufficiently sensitive to be used as the principal test in the follow-up management of low-risk patients with DTC and that the routine use of diagnostic whole body scanning in follow-up should be discouraged. On the basis of the foregoing, we propose a surveillance guideline using TSH-stimulated Tg levels for patients who have undergone total or near-total thyroidectomy and 131I ablation for DTC and have no clinical evidence of residual tumor with a serum Tg below 1 μg/liter during THST.

scholarly journals Clinical use of recombinant human TSH in thyroid cancer patients

2000 ◽  
pp. 557-563 ◽  
Author(s):  
M Schlumberger ◽  
M Ricard ◽  
F Pacini
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Cancer Patients ◽  
Recurrent Disease ◽  
Clinical Use ◽  
Follicular Thyroid Cancer ◽  
Safe Alternative ◽  
Thyroid Hormone Withdrawal ◽  
Recombinant Human Tsh

Recombinant human TSH (rhTSH) is an effective and safe alternative to thyroid hormone withdrawal during the post-surgical follow-up of papillary and follicular thyroid cancer. Its clinical efficiency for the detection of persistent and recurrent disease is similar to that of thyroid hormone withdrawal. The main purpose for its use is to avoid hypothyroidism.

scholarly journals Sick leave for follow-up control in thyroid cancer patients: comparison between stimulation with Thyrogen and thyroid hormone withdrawal

2007 ◽  
Vol 156 (5) ◽  
pp. 531-538 ◽  
Author(s):  
I Borget ◽  
C Corone ◽  
M Nocaudie ◽  
M Allyn ◽  
S Iacobelli ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Sick Leave ◽  
Cancer Patients ◽  
Human Thyroid ◽  
Thyroid Hormone Withdrawal ◽  
The Mean ◽  
The Cost ◽  
Active Patients

Introduction: The clinical benefits of recombinant human thyroid-stimulating hormone (rhTSH; Thyrogen) are well established as an alternative stimulation procedure to thyroid hormone withdrawal in the diagnostic follow-up of thyroid cancer patients. By avoiding periods of hypothyroidism, patients do not suffer from a decreased quality of life and keep their ability to work. This study compared the frequency, the duration and the cost of sick leave for follow-up control between rhTSH and withdrawal. Methods: The study population consisted of patients with thyroid carcinoma first treated by thyroidectomy and radioiodine ablation. Patients were recruited at their control visit between October 2004 and May 2006 in three hospitals, both prospectively and retrospectively. Collection data consisted of patient information, job characteristics and duration of sick leave during the month before and the month after control. The valuation of sick leave used the friction cost method. Results: Among the 306 patients included, 292 (95%) completed the entire questionnaire. The mean age was 46.7 years. Among the 194 active patients, patients treated with rhTSH, when compared with patients treated by withdrawal, were less likely to require sick leave (11 vs 33%; P=0.001). The mean duration of sick leave was shorter (3.1 vs 11.2 days; P=0.002) and indirect costs due to absenteeism accounted for €454 ± 1673 vs €1537 ± 2899 for withdrawal stimulation. Conclusion: For active patients, rhTSH treatment reduced the length and the cost of sick leave by 8.1 days and €1083 per control respectively, when compared with withdrawal treatment.

Sequential Follow-up of Serum Thyroglobulin and Whole Body Scan in Thyroid Cancer Patients without Initial Metastasis

Thyroid ◽  
2006 ◽  
Vol 16 (12) ◽  
pp. 1273-1278 ◽  
Author(s):  
Shu-Hua Huang ◽  
Pei-Wen Wang ◽  
Yu-Erh Huang ◽  
Fong-Fu Chou ◽  
Rue-Tsuan Liu ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Patients ◽  
Whole Body ◽  
Whole Body Scan ◽  
Body Scan ◽  
Serum Thyroglobulin ◽  
Initial Metastasis

Positive Predictive Value of Detectable Stimulated Tg During the First Year After Therapy of Thyroid Cancer and the Value of Comparison with Tg-Ablation and Tg Measured After 24 Months

Thyroid ◽  
2006 ◽  
Vol 16 (11) ◽  
pp. 1145-1149 ◽  
Author(s):  
Maristane M. A. Valadão ◽  
Pedro W. S. Rosário ◽  
Michelle A. R. Borges ◽  
Graciela B. C. Costa ◽  
Leonardo L. Rezende ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
First Year

SONOGRAPHIC FOLLOW-UP OF PATIENTS WITH DIFFERENTIATED THYROID CARCINOMA: A COMPARISON OF THE ULTRASOUND ELASTOGRAPHY, POWER DOPPLER ULTRASOUND, AND B-MODE ULTRASOUND FEATURES IN DETECTING MALIGNANT LYMPH NODES

2019 ◽  
Vol 25 (10) ◽  
pp. 1049-1055
Author(s):  
Berna İmge Aydoğan ◽  
Ugur Ünlütürk ◽  
Funda Seher Özalp Ateş ◽  
Murat Faik Erdoğan
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Positive Predictive Value ◽  
Lymph Nodes ◽  
Predictive Value ◽  
Differentiated Thyroid Cancer ◽  
Power Doppler ◽  
Ultrasound Elastography ◽  
Malignant Lymph Nodes

Objective: The aim of this study was to assess and compare the diagnostic power of B-mode ultrasonography (US), power Doppler US (PD), and ultrasound elastography (USE) in detecting malignant lymph nodes (LNs) during follow-up of patients who were operated on for differentiated thyroid cancer (DTC). Methods: In this prospective study, a total of 103 cervical LNs having suspicious malignant features from 72 patients with DTC were examined using US, PD, and USE. USE scores were classified from 1 to 3 according to the presence of elasticity (1, soft; 2, intermediate; 3, hard). The strain ratios (SRs) of all LNs were calculated according to adjacent muscle tissue. Results: The most-sensitive ultrasonographic features were hilum loss and hypoechogenicity, with 94.4% and 80.6% sensitivity and 93.5% and 84.4% negative predictive value, respectively. The most-specific feature was the presence of cystic component, with 98.5% specificity and 85.7% positive predictive value. Presence of diffuse/chaotic or irregular vascularity in PD had 47.2% sensitivity and 83.6% specificity in predicting metastasis. In USE, the sensitivity and specificity of score 3 were 56.7% and 74.2%, respectively. The median SR of metastatic LNs was higher than that of benign LNs (median SR [min–max], 3.0 [0.16 and 29] vs. 1.89 [0.26 and 37.9]), but the difference was not significant ( P = .07). Multivariate logistic regression analyses revealed 4.9-, 6.6-, and 10-fold increases in metastasis risk for short/long axis ratio ≥0.5, nodal vascularity, and score 3 USE, respectively ( P<.05). Conclusion: While USE had higher sensitivity, PD had higher specificity in detecting malignant LNs, but none of these techniques was as sensitive and specific as gray-scale US features. Abbreviations: CI = confidence interval; DTC = differentiated thyroid cancer; LN = lymph node; LN-Tg = lymph node–thyroglobulin; NPV = negative predictive value; PD = power Doppler; PPV = positive predictive value; ROI = region of interest; SR = strain ratio; US = ultrasonography; USE = ultrasound elastography

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