Thyroid Cancer Coverage from Every Angle
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Serum Thyroglobulin Levels May Provide Therapeutic Insights in Thyroid Cancer

By: Joseph Cupolo
Posted: Wednesday, May 20, 2020

In a recently published study in Cancers centering on differentiated thyroid cancer, investigators examined the association among preoperative serum thyroglobulin levels, tumor burden, and the extent of differentiated thyroid cancer. As tumor burden (ie, primary tumor size and the number of metastasized lymph nodes) and tumor extent (ie, the presence of lateral metastasized lymph nodes and distant metastasis) increased, so did preoperative serum thyroglobulin levels. According to Hosu Kim, MD, of Gyeongsang National University College of Medicine, Changwon, Korea, and colleagues, preoperative measurement of serum thyroglobulin levels may shed more light on metastasized lymph nodes and in turn improve surgical outcomes.

The authors noted that the conventional method for detecting metastasis of differentiated thyroid cancer to the lymph nodes is high-resolution ultrasonography. However, approximately one-third of patients with papillary thyroid carcinoma may have metastasized lymph nodes that are missed by preoperative ultrasonography.   

In this study, 4,738 patients with differentiated thyroid cancer were evaluated for preoperative serum thyroglobulin levels. Metastasis to the lymph nodes was present in 1,982 patients (49.2%) patients. A total of 138 patients underwent a secondary operation after cancer recurrence. The 5-year recurrence-free survival rate was 96.2%.

The investigators then set out to analyze tumor burden and cancer prognosis by evaluating preoperative serum thyroglobulin levels. It was also determined that with deciles of increasing preoperative thyroglobulin levels, there was a statistically significant increase in the mean size of the primary tumor and in the mean number of malignant lymph nodes. Recurrence rates also increased with rising preoperative serum thyroglobulin levels.

“Preoperative thyroglobulin levels can predict the extent of malignant lymph nodes and the severity of differentiated thyroid cancer,” the authors commented. “The results obtained suggest that preoperative measurement of thyroglobulin levels may help to optimize surgical planning in newly diagnosed patients, reducing the number of reoperations and improving prognosis.”

Disclosure: The authors reported no conflicts of interest.

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