Observational studyThe Journal of clinical endocrinology and metabolism2025
Data-driven Thyroglobulin Cutoffs for Low- and Intermediate-risk Thyroid Cancer Follow-up: ITCO Real-world Analysis.
Observational study in The Journal of clinical endocrinology and metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- [New developments in endocrinology/diabetology].Innere Medizin (Heidelberg, Germany) · 2026Review
- Multidisciplinary team diagnosis and treatment of well-differentiated thyroid carcinoma: current landscape and future prospects.The oncologist · 2026Review
- Data-driven Thyroglobulin Cutoffs for Low- and Intermediate-risk Thyroid Cancer Follow-up: ITCO Real-world Analysis.The Journal of clinical endocrinology and metabolism · 2025Observational
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Authors and funding
45 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextThe utility of thyroglobulin (Tg) in the follow-up of patients with differentiated thyroid cancer has been well-documented. Although third-generation immunoassays have improved accuracy, limitations persist (interfering anti-Tg antibodies and measurement variability). Evolving treatment strategies require a reevaluation of Tg thresholds for optimal patient management.
objectiveTo assess the performance of serum Tg testing in 2 populations: patients receiving total thyroidectomy and radioiodine remnant ablation (RRA) or treated with thyroidectomy alone.
designProspective observational study.
settingCenters contributing to the Italian Thyroid Cancer Observatory database. PATIENTS: We included 540 patients with 5 years of follow-up and negative anti-Tg antibodies.
interventionsSerum Tg levels assessed at 1-year follow-up visit.
main outcome measureDetection of structural disease within 5 years of follow-up.
resultsAfter excluding 26 patients with structural disease detected at any time point, the median Tg did not differ between patients treated with or without radioiodine. Data-driven Tg thresholds were established based on the 97th percentile of Tg levels in disease-free individuals: 1.97 ng/mL for patients undergoing thyroidectomy alone (lower than proposed by the Memorial Sloan Kettering Cancer Center protocol and ESMO Guidelines, yet demonstrating good predictive ability, with a negative predictive value of 98% and 0.84 ng/mL for patients receiving postsurgical RRA. High sensitivity and negative predictive value supported the potential of these thresholds in excluding structural disease.
conclusionThis real-world study provides evidence for the continued reliability of 1-year serum Tg levels. The data-driven Tg thresholds proposed offer valuable insights for clinical decision-making in patients undergoing total thyroidectomy with or without RRA.
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