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Comparison of Prognostic Value Between Stimulated and Nonstimulated Thyroglobulins in Differentiated Thyroid Cancer: A Retrospective Study

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Abstract

Purpose

The growing incidence of differentiated thyroid cancer (DTC) demands dependable prognostic factors to guide follow-up and treatment plans. This study investigated the prognostic value of response to therapy (RTT) assessment using TSH stimulated-thyroglobulin (sti-Tg) and nonstimulated-thyroglobulin (nonsti-Tg) and evaluates whether RTT using nonsti-Tg (nonstiRTT) can replace RTT using sti-Tg (stiRTT) in clinical practice to improve patients’ quality of life during assessment.

Methods

We enrolled 419 DTC patients who underwent total thyroidectomy, radioactive iodine (RAI) therapy, and Tg assessment. Patients with structural incomplete responses were excluded. Initial RTT assessments based on the 2015 American Thyroid Association guidelines (excellent response; ER, indeterminate response, biochemical incomplete response) were performed 6–24 months after RAI therapy. The second RTT assessments were performed 6–24 months after the first assessment. Statistical analysis for recurrence-free survival (RFS) was done with the log-rank test for stiRTT and nonstiRTT.

Results

Although initial stiRTT and nonstiRTT were significant predictors for RFS (p < 0.0001), stiRTT provided better RFS prediction than nonstiRTT. The RFS analysis of the second RTT assessment demonstrated statistical significance only for stiRTT (p < 0.0001). In 116 patients classified as ER on initial stiRTT, there was no RFS difference between patients classified as ER on either second stiRTT or nonstiRTT.

Conclusion

The prognostic power of stiRTT surpasses that of nonstiRTT in both the initial and second RTT assessment. Nevertheless, among patients classified as ER on initial stiRTT, a second stiRTT may not be required for those classified as ER on the second nonstiRTT.

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Data Availability

The datasets for this study will not be made publicly available because this study is not open for public use.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Kyungpook National University Hospital, 130 Dongdeok-Ro, Jung Gu, Daegu, Republic of Korea, 41944

    Junik Son, Chae Moon Hong, Do-Hoon Kim, Jaetae Lee & Byeong-Cheol Ahn

  2. Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea

    Shin Young Jeong, Sang-Woo Lee, Jaetae Lee & Byeong-Cheol Ahn

  3. Department of Nuclear Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea

    Shin Young Jeong & Sang-Woo Lee

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  1. Junik Son
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  7. Byeong-Cheol Ahn
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Contributions

The study was designed by Chae Moon Hong, and Byeong-Cheol Ahn. Material preparation and data collection were performed by Chae Moon Hong, and Junik Son. The first draft of the manuscript was written by Junik Son, and Chae Moon Hong and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Byeong-Cheol Ahn.

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Competing Interests

Junik Son, Chae Moon Hong, Do-Hoon Kim, Shin Young Jeong, Sang-Woo Lee, Jaetae Lee, Byeong-Cheol Ahn declare no competing interests.

Ethics Approval and Consent to Participate

This study was performed in accordance with the ethical standards laid down in the Helsinki Declaration of 1964 and its later amendments or comparable ethical standards. Because this is a retrospective review of the data, the requirement for an informed consent was waived by the KNUH institutional review board (No. 2019–06-019).

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Son, J., Hong, C.M., Kim, DH. et al. Comparison of Prognostic Value Between Stimulated and Nonstimulated Thyroglobulins in Differentiated Thyroid Cancer: A Retrospective Study. Nucl Med Mol Imaging 57, 257–264 (2023). https://doi.org/10.1007/s13139-023-00811-8

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  • DOI: https://doi.org/10.1007/s13139-023-00811-8

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