The Prognostic Power of Preablation Stimulated Thyroglobulin in Children With Differentiated Thyroid Cancer

Nesari Javan, F; Askari, E; Shafiei, S; Roshanravan, V; Aghaei, A; Ayati, N; Zakavi, SR

Author(s): Nesari Javan, F; Askari, E; Shafiei, S; Roshanravan, V; Aghaei, A; Ayati, N; Zakavi, SR;
Details: Publication Year 2024-03,Volume 30,Issue #3,Page 209-217
Journal Title: Endocrine Practice
Publication Type: Research article
Abstract: OBJECTIVE: To analyze prognostic factors in children with differentiated thyroid carcinoma (DTC) who have been treated in a single center in the last 27 years. METHODS: We studied 126 children (≤18 years old) who have been treated with near-total thyroidectomy followed by radioiodine therapy and thyroid hormone replacement. Follow-up of the patients was done 2, 6, and 12 months after treatment and then by yearly evaluation. Response to treatment was defined according to the American Thyroid Association guidelines. RESULTS: Papillary thyroid cancer was the main pathology (93.7%), and 52.4% of the patients had lymph node metastasis at presentation, which was extensive (>5) in 30% of the patients. Distant metastasis was seen in 8.8%. The mean initial dose of I-131 was 74 ± 42.2 MBq/kg. The median follow-up was 59 months and the median time to achieve an excellent response was 29 months. The preablation stimulated thyroglobulin (psTg) level was 202.4 ± 301.8 ng/mL in patients with first-year incomplete response compared with 11.2 ± 17.5 ng/mL in others (P =.001). Furthermore, using logistic regression, the psTg level was found to be the only significant predictor of distant metastasis, and psTg ≥ 13.75 ng/mL was the most powerful predictor of first-year incomplete response. Moreover, distant metastasis was more common in boys than in girls, and it took longer time for boys to achieve an excellent response. CONCLUSION: The psTg level was the only significant predictor of distant metastases in children with DTC, and psTg ≥ 13.75 ng/mL was the most powerful predictor of first-year incomplete response.
Publisher: Elsevier
Keywords: Male; Child; Female; Humans; Adolescent; *Thyroglobulin; Prognosis; Iodine Radioisotopes/therapeutic use; *Thyroid Neoplasms/radiotherapy/surgery/pathology; Thyroidectomy; Retrospective Studies; pediatric; risk factors; thyroglobulin; thyroid cancer
Department(s): Cancer Imaging
Publisher's Version: https://doi.org/10.1016/j.eprac.2023.12.005
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-04-16 01:22:37

Last Modified: 2024-04-16 01:23:00