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Thyroid Cancer Patients With No Evidence of Disease: The Need for Repeat Neck Ultrasound
Thyroid Cancer Patients With No Evidence of Disease: The Need for Repeat Neck Ultrasound
- Source :
- The Journal of Clinical Endocrinology & Metabolism. 104:4981-4989
- Publication Year :
- 2019
- Publisher :
- The Endocrine Society, 2019.
-
Abstract
- Context Ultrasonography (US) is considered the most sensitive tool for imaging persistent or recurrent papillary thyroid cancer (PTC) in the neck. Objective To clarify the usefulness of routine neck US in low- and intermediate-risk patients with PTC with no evidence of disease 1 year after thyroidectomy. Design Retrospective analysis of prospectively recorded data. Setting Academic center. Patients Two hundred twenty-six patients with PTC with sonographically normal neck lymph nodes and unstimulated serum thyroglobulin (Tg) levels that were either undetectable ( Interventions Yearly assessment: unstimulated serum Tg level, anti-Tg-antibody (TgAb) titer, TSH levels, and ultrasound examination of neck lymph nodes. Main Outcome Measures Rates of ultrasonographic lymph node abnormalities at the 3-year and last follow-up visits. Results In patients with an undetectable Tg level at the 1-year evaluation, sonographically suspicious neck lymph nodes were found in 1.2% of patients at 3 years and in 1.8% at the last visit [negative predictive values (NPVs) of 1-year Tg < 0.2 ng/mL: 98.8% (95% CI 95.8% to 99.9%) and 98.2% (95% to 99.6%), respectively]. Similar NPVs emerged for low detectable 1-year Tg levels [98.2% (90.3% to 99.9%) and 94.5% (84.9% to 98.9%) at the 3-year and last visits, respectively]. Seventy-five percent of the nodal lesions were likely false positive; none required treatment. Conclusions Low- and intermediate-risk patients with PTC with negative ultrasound findings and unstimulated Tg levels
- Subjects :
- Male
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
Clinical Biochemistry
Thyrotropin
Biochemistry
Gastroenterology
Papillary thyroid cancer
0302 clinical medicine
Endocrinology
Risk Factors
follow-up
Medicine
Lymph node
Thyroid cancer
Ultrasonography
Ultrasound
Middle Aged
Treatment Outcome
medicine.anatomical_structure
Thyroid Cancer, Papillary
030220 oncology & carcinogenesis
Predictive value of tests
Disease Progression
Thyroidectomy
Female
Adult
medicine.medical_specialty
030209 endocrinology & metabolism
Context (language use)
Thyroglobulin
03 medical and health sciences
ultrasonography
Predictive Value of Tests
Internal medicine
Humans
False Positive Reactions
Thyroid Neoplasms
Retrospective Studies
business.industry
Biochemistry (medical)
Retrospective cohort study
medicine.disease
Lymph Nodes
business
Neck
Follow-Up Studies
Subjects
Details
- ISSN :
- 19457197 and 0021972X
- Volume :
- 104
- Database :
- OpenAIRE
- Journal :
- The Journal of Clinical Endocrinology & Metabolism
- Accession number :
- edsair.doi.dedup.....2010a1613dc848ad7bb44625b78c6732
- Full Text :
- https://doi.org/10.1210/jc.2019-00962