Thyroglobulin Cutoffs after Total Thyroidectomy Without Radioiodine in Low- to Intermediate-Risk Thyroid Cancer: A Multicenter Cohort Study
Authors' conclusion
Unstimulated Tg levels are strongly associated with the risk of structural recurrence in patients with DTC who have undergone total thyroidectomy without RAI. The current cutoff values of 0.2 ng/mL and 5.0 ng/mL were clinically relevant, and Tg kinetics over time further improved risk stratification. These findings provide the first large-scale evidence from an East Asian cohort and underscore the importance of early, serial Tg assessment in this growing patient population.
Study context
- Population
- Patients with low- to intermediate-risk differentiated thyroid cancer (DTC) after total thyroidectomy without radioactive iodine (RAI), 11 Korean tertiary hospitals
- Participants
- 9,753 patients
- Outcome
- Structural recurrence; optimal unstimulated Tg cutoffs (ROC and survival analyses)
- Follow-up
- Tg at 6, 12 and 24 months postoperatively
Methodological detailsmulticentre, 11 Korean tertiary hospitals
- Multicentre
- 11 Korean tertiary hospitals
Main finding
As reported in the abstract
Optimal thyroglobulin (Tg) cutoff
0.3 ng/mL
AUC at 6 months
0.815
AUC at 12 months
0.772
AUC at 24 months
0.816
Observational data: associations, not effects.
Further findings
Korean Thyroid Association (KTA) cutoffs
- Tg ≥0.2 ng/mL (KTA excellent-response cutoff) showed high sensitivity for recurrence
- Tg ≥5.0 ng/mL at 6 months (KTA biochemical incomplete response) independently predicted elevated recurrence risk
Recurrence-free survival by Tg level and Tg kinetics
- Stepwise declines in recurrence-free survival with increasing Tg levels
- Even Tg <0.2 or <0.3 ng/mL associated with recurrence if levels rose over time
Original publication
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