Dynamic Risk Assessment Using Unstimulated Serum Thyroglobulin Level and Thyroglobulin Doubling Rate after Total Thyroidectomy for Papillary Thyroid Carcinoma
Authors' conclusion
This study demonstrates the prognostic value of postoperative uTg and Tg-DR in Tg-Ab-negative patients with PTC under TSH suppression after total thyroidectomy.
Study context
- Population
- Tg antibody (Tg-Ab)-negative patients after curative intent total thyroidectomy for papillary thyroid carcinoma (PTC) without distant metastasis; Unstimulated Tg (uTg) measured 1–3 months post-surgery under TSH suppression (<0.1 mIU/mL)1,212 categorised (no adjuvant RAI)
- Participants
- 1,818 patients
- Exposure
- Categories by postoperative uTg and Tg-doubling rate (Tg-DR)
- Outcome
- Lymph node recurrence-free survival by uTg/Tg-DR category (no adjuvant RAI)
- Follow-up
- Median 7.2 years
Main finding
As reported in the abstract
HR for lymph node recurrence (CI)P value
Category Avs Category B
5.083(1.994–12.955)
P < 0.001Category Bvs Category C
2.654(1.462–4.824)
P = 0.001- Between Category C and Category D · estimate outside its printed interval
- HR for lymph node recurrence 27.420 (CI 15.100–4.980); P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Distant recurrence-free survival (DR-FS)B vs C · did not differ | P = 0.419 |
| Distant recurrence-free survival (DR-FS)D vs B and C · better in D | P < 0.001 |
| Distant recurrence-free survival (DR-FS)A vs B and C · tended to be worse in A | P = 0.087 |
Recurrence in whole cohort · median follow-up 7.2 years (25th percentile 4.7, 75th percentile 9.8)
- Local recurrence
- 88 (4.8%)
- Distant recurrence
- 32 (1.8%)
Local and distant recurrence by uTg ≥3 ng/mL (n=131)
- uTg ≥3 ng/mL more likely to have local and distant recurrences in univariate and multivariable analyses
- P < 0.001
Distant recurrence-free survival (DR-FS)
- A high-risk, B and C intermediate-risk, D low-risk for distant recurrence
Original publication
Dynamic Risk Assessment Using Unstimulated Serum Thyroglobulin Level and Thyroglobulin Doubling Rate after Total Thyroidectomy for Papillary Thyroid Carcinoma. Thyroid. Published 11 August 2025. doi:10.
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