Stimulated postoperative thyroglobulin levels may be useful for predicting the risk for persistent disease in children and adolescents with differentiated thyroid cancer, study data show.
Ana Luiza Maia, MD, PhD, of the thyroid section, endocrine division, Hospital de Clínicas de Porto Alegre in Brazil, and colleagues evaluated 32 children and adolescents with differentiated thyroid cancer (DTC; mean age at diagnosis, 14.7 years) to determine potential prognostic factors. Participants attended a thyroid outpatient clinic from 2000 to 2015.
Most participants had papillary thyroid carcinoma (96.9%); one had follicular thyroid carcinoma.
At 1 year of follow-up, 51.9% of participants were disease-free, 22.2% had persistent biochemical disease and 25.9% had persistent structural disease. After a median 5 years of follow-up, 55.6% of participants were disease-free, 22.2% had persistent biochemical disease and 22.2% had persistent structural disease.
Lymph node metastasis (P = .003) and distant metastasis (P = .01) were more common in participants with persistent disease, and they had higher stimulated postoperative thyroglobulin (P < .001).
Total thyroidectomy was performed in all participants, and 90.6% received radioactive iodine therapy. Seventeen participants had data available on disease status and stimulated postoperative thyroglobulin; median time between surgery and stimulated postoperative thyroglobulin was 3 months.
Participants who were disease-free had a lower median stimulated postoperative thyroglobulin level compared with participants with persistent disease (P < .001). The optimal cutoff point to predict disease-free status was a stimulated postoperative thyroglobulin level of 31.5 ng/mL with a sensitivity and specificity of 100%.
“We have demonstrated that lymph node metastasis, distant metastasis and [stimulated postoperative thyroglobulin] are useful prognostic factors in young patients with DTC,” the researchers wrote. “Of particular interest, [stimulated postoperative thyroglobulin] seems to have a promising role as a tool for identifying children and adolescents with DTC at high risk of persistent disease.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.