alexa High Negative Predictive Value (NPV) Of Undetectable TSH Stimulated Tg For Disease Recurrence In Both Low And High Risk Differentiated Thyroid Cancer
ISSN: 2167-7948

Journal of Thyroid Disorders & Therapy
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Research Article

High Negative Predictive Value (NPV) Of Undetectable TSH Stimulated Tg For Disease Recurrence In Both Low And High Risk Differentiated Thyroid Cancer

SGA de Meer1*, MR Vriens1, GD Valk2, IHM Borel Rinkes1 and B de Keizer3
1Department of Surgery, University Medical Center Utrecht, The Netherlands
2Department of Endocrinology, University Medical Center Utrecht, The Netherlands
3Department of Nuclear Medicine, University Medical Center Utrecht, The Netherlands
Corresponding Author : SGA de Meer, M.D
Department of Surgery
University Medical Center Utrecht, The Netherlands
Tel: +003188-7559884
Fax: 088-7555459
E-mail: [email protected]
Received January 24, 2014; Accepted March 19, 2014; Published March 21, 2014
Citation: de Meer SGA, Vriens MR, Valk GD, Borel Rinkes IHM, de Keizer B (2014) High Negative Predictive Value (NPV) of Undetectable TSH Stimulated Tgfor Disease Recurrence in both Low and High Risk Differentiated Thyroid Cancer. Thyroid Disorders Ther 3:149. doi:10.4172/2167-7948.1000149
Copyright: © 2014 de Meer SGA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Abstract

The extend, intensity and timing of the follow-up of differentiated thyroid cancer (DTC) patients remains unclear. Recent studies identified an undetectable TSH stimulated Tg measurement after one year as a prognostic factor for the risk of recurrence during further follow-up, thereby further dividing patients based on risk for recurrence. Because patients experience their disease on an emotional basis rather than related to actual disease severity, follow-up should be targeted to detect recurrence without ‘over-investigating’ patients. The aim of our study was to investigate the recurrence rate in high and low risk patients with DTC and the need for repeated (TSH stimulated) Tg measurement. Methods: We retrospectively reviewed the medical records of 264 DTC patients with absent Tg-Ab and identified the patients with persistent/ recurrent disease. We compared recurrence rates between patients with and without detectable TSH-stimulated Thyroglobulin levels. Results: Recurrence rate was significantly higher in patients with positive stimulated Tg measurement within one year after treatment (p<0.001) While the negative predictive value (NPV) of an undectectable Tg was 0.97 for both high and low risk patients. The percentage of high risk patients with undetectable Tg after one year however is significantly lower compared to low risk patients. Conclusion: Recurrence rates for patients with undectable TSH stimulated Tg one year after initial diagnosis is very low and identical for low and high risk patients. Therefore it seems sensible to discharge patients from a strict specialist follow-up regime.

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