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Lymph Node Status Influences Follow-Up Thyroglobulin Levels in Papillary Thyroid Cancer

Annals of Surgical Oncology volume 15, Article number: 2827 (2008) Cite this article

Abstract

Background

Elevated thyroglobulin (Tg) levels post surgery are associated with disease recurrence in papillary thyroid carcinoma (PTC). The aim of this study is to determine which clinicopathological factors influence Tg elevation following surgery and radio-iodine ablation (RAI) for PTC.

Methods

A retrospective study of consecutive patients undergoing total thyroidectomy and RAI for PTC was carried out. Prophylactic central neck dissection (CND) was performed if the diagnosis of PTC was made preoperatively. Lateral neck dissection (LND) was guided by ultrasound findings. RAI was administered 6 weeks postoperatively. Stimulated Tg levels were measured at 12 months.

Results

One hundred patients with PTC were studied. Forty patients had routine CND. The median tumour size was 15 mm. Median stimulated Tg level at 12 months was 0.3 μg/L. On multivariate analysis the number of metastatic lymph nodes removed had a significant positive association with serum Tg levels (P = 0.003). The total number of lymph nodes resected had a significant inverse relationship with serum Tg levels (P = 0.04). Tumour size, multifocality, vascular and capsular invasion did not appear to have significant correlation with Tg levels.

Conclusion

Lymph node metastases are associated with increased postablative Tg levels in PTC. More complete lymphadenectomy is associated with lowering of Tg levels.

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Abbreviations

PTC:

Papillary thyroid carcinoma

Tg:

Thyroglobulin

RAI:

Radio ablative iodine-131

TT:

Total thyroidectomy

CND:

Central neck dissection

LND:

Lateral neck dissection

LN:

Lymph nodes

CI:

Confidence interval

WBS:

Whole-body scan.

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Acknowledgements

We thank Pamela Edhouse and Macushla Myles for their effort in maintaining our thyroid cancer database.

Funding

Funding for establishment of a thyroid cancer database was provided through a grant from the New South Wales Cancer Institute.

Author information

Affiliations

  1. Department of Endocrine and Oncology Surgery, University Clinic, University of Sydney Endocrine Surgical Unit, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia

    Tsu-Hui (Hubert) Low MBBS, Leigh Delbridge MD, Stan Sidhu PhD & Mark Sywak MBBS

  2. Department of Endocrinology, Royal North Shore Hospital, St Leonards, NSW, Australia

    Dianna Learoyd PhD & Bruce Robinson MD

  3. Department of Nuclear Medicine, Royal North Shore Hospital, St Leonards, NSW, Australia

    Paul Roach MBBS

Authors
  1. Tsu-Hui (Hubert) Low MBBS
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  2. Leigh Delbridge MD
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  3. Stan Sidhu PhD
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  4. Dianna Learoyd PhD
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  5. Bruce Robinson MD
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  6. Paul Roach MBBS
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  7. Mark Sywak MBBS
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Corresponding author

Correspondence to Mark Sywak MBBS.

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Low, TH.(., Delbridge, L., Sidhu, S. et al. Lymph Node Status Influences Follow-Up Thyroglobulin Levels in Papillary Thyroid Cancer. Ann Surg Oncol 15, 2827 (2008). https://doi.org/10.1245/s10434-008-0049-1

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  • DOI: https://doi.org/10.1245/s10434-008-0049-1

Keywords

  • Thyroid neoplasms
  • Papillary carcinoma
  • Thyroglobulin
  • Neck dissection
  • Iodine radioisotopes