Annals of Surgical Oncology Cite Track
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
10.1245/s10434-008-0049-1
Annals of Surgical Oncology 15:2827-2832 (2008)
© 2008 Society of Surgical Oncology
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Low, T.-H.
Right arrow Articles by Sywak, M.
PubMed
Right arrow Articles by Low, T.-H.
Right arrow Articles by Sywak, M.

Original Article

Lymph Node Status Influences Follow-Up Thyroglobulin Levels in Papillary Thyroid Cancer

Tsu-Hui (Hubert) Low, MBBS1, Leigh Delbridge, MD1, Stan Sidhu, PhD1, Dianna Learoyd, PhD2, Bruce Robinson, MD2, Paul Roach, MBBS3 and Mark Sywak, MBBS1

1 Department of Endocrine and Oncology Surgery, University Clinic, University of Sydney Endocrine Surgical Unit, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
2 Department of Endocrinology, Royal North Shore Hospital, St Leonards, NSW, Australia
3 Department of Nuclear Medicine, Royal North Shore Hospital, St Leonards, NSW, Australia

Correspondence: Address correspondence and reprint requests to: Mark Sywak, MBBS; E-mail: marksywak{at}nebsc.com.au

Background: Elevated thyroglobulin (Tg) levels post surgery are associated with disease recurrence in papillary thyroid carcinoma (PTC). The aim of this study is to determine which clinicopathological factors influence Tg elevation following surgery and radio-iodine ablation (RAI) for PTC.

Methods: A retrospective study of consecutive patients undergoing total thyroidectomy and RAI for PTC was carried out. Prophylactic central neck dissection (CND) was performed if the diagnosis of PTC was made preoperatively. Lateral neck dissection (LND) was guided by ultrasound findings. RAI was administered 6 weeks postoperatively. Stimulated Tg levels were measured at 12 months.

Results: One hundred patients with PTC were studied. Forty patients had routine CND. The median tumour size was 15 mm. Median stimulated Tg level at 12 months was 0.3 µg/L. On multivariate analysis the number of metastatic lymph nodes removed had a significant positive association with serum Tg levels (P = 0.003). The total number of lymph nodes resected had a significant inverse relationship with serum Tg levels (P = 0.04). Tumour size, multifocality, vascular and capsular invasion did not appear to have significant correlation with Tg levels.

Conclusion: Lymph node metastases are associated with increased postablative Tg levels in PTC. More complete lymphadenectomy is associated with lowering of Tg levels.

Key Words: Thyroid neoplasms • Papillary carcinoma • Thyroglobulin • Neck dissection • Iodine radioisotopes

Abbreviations: PTC, Papillary thyroid carcinoma • Tg, Thyroglobulin • RAI, Radio ablative iodine-131 • TT, Total thyroidectomy • CND, Central neck dissection • LND, Lateral neck dissection • LN, Lymph nodes • CI, Confidence interval • WBS, Whole-body scan






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2008 by the Society of Surgical Oncology.