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

Junik Son; Chae Moon Hong; Do-Hoon Kim; Shin Young Jeong; Sang-Woo Lee; Jaetae Lee; Byeong-Cheol Ahn

doi:10.1007/s13139-023-00811-8

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

Nucl Med Mol Imaging. 2023 Dec;57(6):257-264. doi: 10.1007/s13139-023-00811-8. Epub 2023 Jul 3.

Authors

Junik Son¹, Chae Moon Hong¹, Do-Hoon Kim¹, Shin Young Jeong^{2

3}, Sang-Woo Lee^{2

3}, Jaetae Lee^{1

2}, Byeong-Cheol Ahn^{1

2}

Affiliations

¹ Department of Nuclear Medicine, Kyungpook National University Hospital, 130 Dongdeok-Ro, Jung Gu, Daegu, Republic of Korea 41944.
² Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
³ Department of Nuclear Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea.

PMID: 37982102
PMCID: PMC10654278 (available on 2024-12-01)
DOI: 10.1007/s13139-023-00811-8

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.

Supplementary information: The online version contains supplementary material available at 10.1007/s13139-023-00811-8.

Keywords: Nonstimulated Tg; Response to therapy; Stimulated Tg; Thyroglobulin; Thyroid cancer.

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