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Serum thyroglobulin predicts thyroid remnant ablation failure with 30 mCi iodine-131 treatment in patients with papillary thyroid carcinoma.
MedLine Citation:
PMID:  21191314     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Most patients with differentiated thyroid cancer are treated with radioiodine (131-I) after thyroidectomy. The characteristics predictive of successful remnant ablation with low activities of 131-I are ill defined and could help stratify patients into those who should receive higher activities.
METHODS: In a case series of 193 consecutive patients with papillary thyroid cancer who underwent total thyroidectomy and received 30 mCi (1110 MBq) of 131-I, we assessed the percentage of successful radioremnant ablation as defined by a composite of scintigraphic and biochemical endpoints. Clinical, histological, scintigraphic, and biochemical covariables were analyzed to identify associations with treatment failure.
RESULTS: Successful radioremnant ablation with low-activity 131-I was obtained in 78% of the entire cohort of patients. The presence of limited microscopic extrathyroidal extension, nodal micrometastases, or an elevated stimulated ablation was associated with failure to ablate the remnant. While accounting for other factors in a multivariable analysis, patients with an ablation thyroglobulin of at least 6 μg/l were at a more than five times greater risk (P<0.001) to fail 30 mCi 131-I remnant ablation.
CONCLUSION: The majority of patients with papillary thyroid carcinoma experienced successful ablation. However, elevated-stimulated ablation thyroglobulin levels were strongly predictive of ablation failure, suggesting that this biochemical marker correlates with a more aggressive tumor profile and identifies those patients who might benefit from additional therapy.
Authors:
Michael Tamilia; Nora Al-Kahtani; Louise Rochon; Michael P Hier; Richard J Payne; Christina A Holcroft; Martin J Black
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Nuclear medicine communications     Volume:  32     ISSN:  1473-5628     ISO Abbreviation:  Nucl Med Commun     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-01-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8201017     Medline TA:  Nucl Med Commun     Country:  England    
Other Details:
Languages:  eng     Pagination:  212-20     Citation Subset:  IM    
Affiliation:
aDepartment of Medicine, Division of Endocrinology and Metabolism bDepartments of Pathology cOtolaryngology, Head and Neck Surgery dCentre of Clinical Epidemiology and Community Studies, Jewish General Hospital, McGill University, Montreal, Canada.
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