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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

Authors :
Giorgio Grani
Valeria Ramundo
Rosa Falcone
Cosimo Durante
Sebastiano Filetti
Martin Schlumberger
Antonella Verrienti
Teresa Montesano
Laura Giacomelli
Livia Lamartina
Marialuisa Sponziello
Marco Biffoni
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

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