Lymph node status influences follow-up thyroglobulin levels in papillary thyroid cancer

Abstract
Background  Elevated thyroglobulin (Tg) levels post surgery are associated with disease recurrence in papillary thyroid carcinoma (PTC).
The aim of this study is to determine which clinicopathological factors influence Tg elevation following surgery and radio-iodine
ablation (RAI) for PTC.

Methods  A retrospective study of consecutive patients undergoing total thyroidectomy and RAI for PTC was carried out. Prophylactic
central neck dissection (CND) was performed if the diagnosis of PTC was made preoperatively. Lateral neck dissection (LND)
was guided by ultrasound findings. RAI was administered 6 weeks postoperatively. Stimulated Tg levels were measured at 12
months.

Results  One hundred patients with PTC were studied. Forty patients had routine CND. The median tumour size was 15 mm. Median stimulated
Tg level at 12 months was 0.3 μg/L. On multivariate analysis the number of metastatic lymph nodes removed had a significant
positive association with serum Tg levels (P = 0.003). The total number of lymph nodes resected had a significant inverse relationship with serum Tg levels (P = 0.04). Tumour size, multifocality, vascular and capsular invasion did not appear to have significant correlation with Tg
levels.

Conclusion  Lymph node metastases are associated with increased postablative Tg levels in PTC. More complete lymphadenectomy is associated
with lowering of Tg levels.

Content Type Journal ArticleCategory Endocrine TumorsDOI 10.1245/s10434-008-0049-1Authors
Tsu-Hui (Hubert) Low, University of Sydney Endocrine Surgical Unit, Royal North Shore Hospital Department of Endocrine and Oncology Surgery, University Clinic St Leonards NSW 2065 AustraliaLeigh Delbridge, University of Sydney Endocrine Surgical Unit, Royal North Shore Hospital Department of Endocrine and Oncology Surgery, University Clinic St Leonards NSW 2065 AustraliaStan Sidhu, University of Sydney Endocrine Surgical Unit, Royal North Shore Hospital Department of Endocrine and Oncology Surgery, University Clinic St Leonards NSW 2065 AustraliaDianna Learoyd, Royal North Shore Hospital Department of Endocrinology St Leonards NSW AustraliaBruce Robinson, Royal North Shore Hospital Department of Endocrinology St Leonards NSW AustraliaPaul Roach, Royal North Shore Hospital Department of Nuclear Medicine St Leonards NSW AustraliaMark Sywak, University of Sydney Endocrine Surgical Unit, Royal North Shore Hospital Department of Endocrine and Oncology Surgery, University Clinic St Leonards NSW 2065 Australia

Journal Annals of Surgical OncologyOnline ISSN 1534-4681Print ISSN 1068-9265 (Source: Annals of Surgical Oncology)  MedWorm Sponsored Message: Find out how you can get your message across here by sponsoring this MedWorm news feed.