Evidence map›Paper›PMID 29948933›Full record

ArticleEndocrine2018

Assessing the utility of preoperative serum thyroglobulin in differentiated thyroid cancer: a retrospective cohort study.

Rushad Patell, Alexandra Mikhael, Michael Tabet, James Bena, Eren Berber, Christian Nasr

Abstract read
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In one paragraph

Article in Endocrine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Rushad PatellDivision of Hematology/Oncology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA.
Alexandra MikhaelDepartment of Internal Medicine, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. mikhaea@ccf.org.ORCID http://orcid.org/0000-0003-3999-827X
Michael TabetUniversity of Vermont, Burlington, VT, 05405, USA.
James BenaQuantitative Health Sciences Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Eren BerberEndocrinology and Metabolism Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Christian NasrEndocrinology and Metabolism Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSerum thyroglobulin (TG) is used to monitor for recurrence or progression of differentiated thyroid cancer (DTC). The role of preoperative TG measurement is more ambiguous, yet still being used in some centers. We aimed to determine whether preoperative TG correlates with disease stage or metastatic burden.

methodsA retrospective review of patients with TG measured before thyroidectomy was conducted. Data collected included demographics, preoperative TG, pathology, and cancer stage. Associations between preoperative TG levels and size of largest malignant nodule, thyroid gland size, stage of cancer, and presence of metastasis using Wilcoxon rank sum tests and Spearman correlations were performed. Receiver operator curve (ROC) was generated for metastasis status.

resultsOf 598 patients, we excluded those with positive TG antibodies (n = 176); 422 patients were included in the final analysis. Median age was 55 years and 76% were female. Of 78% with malignancy, papillary thyroid cancer was the most frequent (92%). 18% had TG levels >500 ng/mL and 29% <45 ng/mL. 4% had distant metastasis and 18% had lymph node metastasis. Median follow-up was 52 months. Significant positive correlations between preoperative TG and thyroid size (rho 0.49, p < 0.001), and malignant nodule size (rho 0.27, p < 0.001). Using a cut-off of 500 ng/mL, sensitivity to detect metastasis was 10.3% (95% CI 2.5-18.2), specificity 90.0% (95% CI 86.0-93.9). The area under curve for ROC (0.46, 95% CI 0.38-0.54) indicated poor diagnostic ability for metastasis.

conclusionAlthough preoperative TG correlated significantly with the size of the gland and T stage, there was no correlation with metastasis. Preoperative TG is of limited utility in today's value-based healthcare environment.

Indexed as

ThyroidectomyAdultAgedAged, 80 and overFemaleHumansLymphatic MetastasisMaleMiddle AgedPreoperative PeriodRetrospective StudiesThyroglobulinThyroid NeoplasmsYoung AdultThyroglobulinCancerPreoperativeThyroglobulinThyroidThyroidectomy

Identifiers

PMID29948933

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.