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Stimulated Serum Thyroglobulin Level at the Time of First Dose of Radioactive Iodine Therapy Is the Most Predictive Factor for Therapeutic Failure in Patients With Papillary Thyroid Carcinoma

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Abstract

Purpose

To investigate the clinical importance of serum thyroglobulin (Tg) levels just before high-dose I-131 ablation therapy (preablation Tg) for predicting therapeutic failure in patients with papillary thyroid carcinoma (PTC).

Methods

Patients with PTC (n = 132) undergoing total thyroidectomy followed by the first high-dose I-131 ablation therapy (HI-Rx) were included in this retrospective review. Just before HI-Rx, preablation Tg, anti-Tg antibody, and TSH were measured. The patients were followed up for a mean period of 7 months (range 6–23 months) by I-123 whole-body scans (f/u IWBS) and stimulated Tg (f/u Tg). Therapeutic failure was defined by positive f/u IWBS or f/u Tg >2 ng/ml. We classified patients into three groups according to the value of preablation Tg (group 1, <1 ng/ml; group 2, ≥1 and <10 ng/ml; group 3, ≥10 ng/ml) and compared clinical variables to therapeutic response.

Results

Therapeutic failure was noted in 39 patients (29.5 %). On univariate analysis, T stage, tumor size, and preablation Tg were the statistically significant factors that could predict therapeutic failure. After multivariate analysis, preablation Tg was the only independent predictor of therapeutic failure (P < 0.001). The therapeutic failure rate was significantly increased as the preablation Tg level increased (11.3 %, 33.3 %, and 87.5 % in groups 1, 2, and 3, respectively; P < 0.001). Individuals with preablation Tg levels ≥10 ng/ml had 25.5 times greater chance of therapeutic failure than those with levels <10 ng/ml (95 % CI = 5.43–119.60; P < 0.001).

Conclusions

A high preablation Tg level is the most significant predictor of therapeutic failure at the time of first HI-Rx in patients with PTC.

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Conflict of Interest

Hee Jeong Park, Geum-Cheol Jeong, Seong Young Kwon, Jung-Joon Min, Hee-Seung Bom, Ki Seong Park, Sang-Geon Cho, Sae-Ryung Kang, Jahae Kim, Ho-Chun Song, Ari Chong, and Su Woong Yoo declare that they have no conflict of interest.

Ethics Statement

This study protocol was approved by the ethics committee at our hospital and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, 322 Seoyang-ro Hwasun-eup, Hwasun-gun Jeonnam, Korea, 519-763

    Hee Jeong Park, Geum-Cheol Jeong, Seong Young Kwon, Jung-Joon Min & Hee-Seung Bom

  2. Chonnam National University Hospital, Gwangju, Korea

    Ki Seong Park, Sang-Geon Cho, Sae-Ryung Kang, Jahae Kim & Ho-Chun Song

  3. Chosun University Hospital, Gwangju, Korea

    Ari Chong

  4. Gwangju Institute of Science and Technology, Gwangju, Korea

    Su Woong Yoo

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  1. Hee Jeong Park
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Correspondence to Hee-Seung Bom.

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Park, H.J., Jeong, GC., Kwon, S.Y. et al. Stimulated Serum Thyroglobulin Level at the Time of First Dose of Radioactive Iodine Therapy Is the Most Predictive Factor for Therapeutic Failure in Patients With Papillary Thyroid Carcinoma. Nucl Med Mol Imaging 48, 255–261 (2014). https://doi.org/10.1007/s13139-014-0282-4

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