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Αλέξανδρος Γ. Σφακιανάκης

Wednesday, December 2, 2020

Value of thyroglobulin post hemithyroidectomy for cancer: a literature review

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Value of thyroglobulin post hemithyroidectomy for cancer: a literature review

This is a review of the literature on the utility of serum Tg in the follow up of differentiated thyroid cancer following thyroid lobectomy. Tg measurement is not a reliable marker for the detection of persistent/recurrent disease in this scenario.


Abstract

Background

An increasing number of patients with low and moderate risk differentiated thyroid cancer (DTC) are now managed with lobectomy alone. The value of serum thyroglobulin (Tg) in the follow up of these patients remains poorly defined.

Methods

A review of the MEDLINE and EMBASE databases was performed to assess the utility of Tg in the follow up of patients undergoing thyroid lobectomy for DTC.

Results

A total of five retrospective reviews were identified including 1136 patients undergoing hemithyroidectomy with or without prophylactic central neck dissection. The overall locoregional recurrence rate was 3.7%. Changes in serum Tg following hemithyroidectomy for cancer were found to be clinically useful in one study only. The proposed cut‐off value of 30 ng/mL following hemithyroidectomy as a predictor of recurrent disease was not validated by any study.

Conclusion

Serum Tg values are not useful in the follow up of DTC patients managed with lobectomy alone. Good quality neck ultrasound appears to be an effective modality in the detection of locoregional recurrence in these patients while research efforts continue to identify and validate novel biomarkers.

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