TITLE:
Impact of Thyroglobulin on Survival and Prognosis of Differentiated Thyroid Cancer
AUTHORS:
Hanan Ahmed Wahba, Hend Ahmed El-Hadaad, Abeer Hussien Anter, Alaa M. Wafa, Ahmed Negm
KEYWORDS:
Thyroglobulin, Thyroid Cancer, Differentiated Thyroid Cancer, Risky Factors
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.9 No.9,
September
11,
2018
ABSTRACT: Proper assessment of risk factors contributes to the principle management
of differentiated thyroid carcinoma post operatively. Aim of the study: to investigate
the effect of Thyroglobulin (Tg) levels on prognosis together with other risk
factors for Differentiated Thyroid Cancer (DTC). Patients and methods: Medical
records of all patients with DTC presented to Clinical Oncology and Nuclear Medicine Department referred from Diabetes &
Endocrine unit (Internal Medicine Hospital) and Surgery Department Mansoura
University from 2011-2016 were retrospectively reviewed. Patients with distant
metastasis or who lost follow-up were excluded. So data of 220 patients were analyzed.
Data collected included pre-surgical assessment, also surgical
interference either total or near total thyroidectomy with or without lymph
node neck dissection were reviewed. Different prognostic factors that affect progression free survival (PFS) include age, umorsize, ymph node
status, ex, multifocality, capsular infiltration,
vascular invasion and Tg level were evaluated through multivariate analysis.
Results: Most of the patients included were (80%)
with papillary type predominance (80.9%). About 59.5% of cases presented with
tumor size ≤ 2 cm and multifocality was reported in 13.6%. While 30% had lymph
node metastasis, 11% had vascular invasion. Capsular infiltration was observed
in 15% and most of them showed Tg level ≤ 10 ng/ml (68.2%). About 70% received
ablative radioiodine. The 5-year Progression Free Survival (PFS) was 85%. On
multivariate analysis of variable prognostic factors on PFS, we
found that tumor size, age, lymph node status, capsular infiltration,
Tg level and vascular invasion significantly affected PFS (P
= 0.01, 0.005, 0.004, 0.005, 0.02, 0.003) respectively. While sex, pathological
type and multifocality were not (P = 0.9, 0.4, 0.6) respectively. Conclusion: Postoperative
Tg level is a statistically significant prognostic factor together with other
risk factors.