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Basal or stimulated thyroglobulin in evaluating response to treatment in papillary thyroid carcinoma? A retrospective cohort study

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Abstract

Objective

It is not clear whether response to initial treatment in papillary thyroid carcinoma (PTC) patients is best evaluated by measuring thyroglobulin (Tg) in the presence of levothyroxine (BTg) or when stimulated by elevated TSH (STg). The aim of this study was to evaluate whether response to therapy 1 year after initial treatment changes with the use of STg in relation to BTg in PTC patients treated with total thyroidectomy (TT) and radioiodine (131I), and, if observed, to assess which response is better associated with clinical course.

Subjects and methods

This is a retrospective study of 148 PTC patients submitted to TT and 131I. We analyzed the response to therapy (excellent, biochemical incomplete, or indeterminate) at 1 year after initial treatment, using BTg or STg, and compared which method was better associated with “excellent response at final evaluation.”

Results

Twenty-eight patients (20.4%) presented change in response to therapy, with 17 of these (60.7%) presenting a worse response. Response using STg was 1.6 times better associated with proposed outcome [odds ratio (OR) = 4.61; confidence interval 95% (IC95%): 2.13–9.98] than with BTg (OR = 2.84; IC95%: 1.33–6.06).

Conclusion

Response to therapy at 1 year using STg was altered in approximately 20% of cases and therefore proved to be a better predictor of excellent response in the last evaluation.

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Acknowledgements

I would like to thank the Sao Paulo State University—UNESP for the structure that made this study possible and for the funding that helped considerably in carrying out the study received from the following institutions: Institutional Scientific Initiation Scholarship Program from Sao Paulo State University – UNESP (PIBIC – Rectory) and the Research Support Foundation of the State of São Paulo (FAPESP). Furthermore, special thanks to Dr. Gláucia Maria Ferreira da Silva Mazeto who guided the study in a unique way, clarifying all doubts and closely monitoring all stages of production of this article.

Funding

This work was supported by the Research Support Foundation of the State of São Paulo (FAPESP) process 2021/05011–7 and Institutional Scientific Initiation Scholarship Program from Sao Paulo State University – UNESP (PIBIC – Rectory) project ID: 36. All authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Internal Medicine Department, Botucatu Medical School, Sao Paulo State University – Unesp, Botucatu, Brazil

    Leticia Barreto, Deborah Cristina Goulart Ferreira & Gláucia Maria Ferreira da Silva Mazeto

  2. Biosciences Institute, Bioestatistics Department – Unesp, Botucatu, Brazil

    José Eduardo Corrente

  3. Ophthalmology, Otorhinolaryngology and Head and Neck Surgery Department, Botucatu Medical School, Sao Paulo State University – Unesp, Botucatu, Brazil

    Carlos Segundo Paiva Soares & José Vicente Tagliarini

  4. Department of Pathological Anatomy, AC Camargo Cancer Center, São Paulo, Brazil

    Cristiano Claudino Oliveira

  5. Pathology Department, Botucatu Medical School, Sao Paulo State University – Unesp, Botucatu, Brazil

    Simone Antunes Terra

  6. Nuclear Medicine Department, Botucatu Medical School, Sao Paulo State University – Unesp, Botucatu, Brazil

    Sonia Marta Moriguchi & Katia Hiromoto Koga

Authors
  1. Leticia Barreto
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  2. Deborah Cristina Goulart Ferreira
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  9. José Vicente Tagliarini
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  10. Gláucia Maria Ferreira da Silva Mazeto
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Letícia Barreto and Gláucia Maria Ferreira da Silva Mazeto. The first draft of the manuscript was written by Letícia Barreto and Gláucia Maria Ferreira da Silva Mazeto and all authors commented on the previous versions of the manuscript. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to Gláucia Maria Ferreira da Silva Mazeto.

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Ethics approval

This observational, retrospective cohort study was approved by the Research Ethics Committee of Botucatu Faculty of Medicine (FMB) – Sao Paulo State University – UNESP (CAAE no 28223620.1.0000.5411; protocol nº 3.823.265) and reported according to STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines.

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Barreto, L., Ferreira, D.C.G., Corrente, J.E. et al. Basal or stimulated thyroglobulin in evaluating response to treatment in papillary thyroid carcinoma? A retrospective cohort study. Hormones 23, 97–106 (2024). https://doi.org/10.1007/s42000-023-00503-0

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