Pre-operative thyroglobulin measurement for thyroid cancer risk of recurrence and response to therapy

Am J Surg. 2024 Dec:238:115818. doi: 10.1016/j.amjsurg.2024.115818. Epub 2024 Jul 3.

Abstract

Background: Thyroid cancer has an overall favorable prognosis, but no pre-operative biochemical marker has been shown to distinguish between low and high-risk disease or predict response to therapy.

Methods: We retrospectively reviewed 162 patients that underwent thyroid surgery for thyroid cancer between 2006 and 2022 in whom a pre-operative thyroglobulin level (Tg) was measured. We subdivided patients into low, intermediate and high-risk thyroid cancer and based on their response to therapy per ATA guidelines.

Results: We showed that as pre-operative Tg level increased, patients were more likely to have high-risk disease (p ​< ​0.01). We found a linear association between the primary tumor size and high-risk histology with pre-operative Tg (p ​< ​0.01). Pre-operative Tg level was significantly associated with response to therapy following initial surgical management. Specifically, as pre-operative Tg increases, patients were less likely to achieve an excellent response (p ​< ​0.01).

Conclusions: Our retrospective analysis demonstrated that pre-operative Tg is significantly associated with ATA structural risk of recurrence and response to therapy and may have the potential to guide initial therapy and follow-up management.

Keywords: Response to therapy; Risk of recurrence; Thyroglobulin; Thyroid cancer.

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor / blood
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local* / blood
  • Neoplasm Recurrence, Local* / epidemiology
  • Preoperative Care / methods
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Thyroglobulin* / blood
  • Thyroid Neoplasms* / blood
  • Thyroid Neoplasms* / diagnosis
  • Thyroid Neoplasms* / pathology
  • Thyroid Neoplasms* / surgery
  • Thyroidectomy*
  • Treatment Outcome

Substances

  • Thyroglobulin
  • Biomarkers, Tumor