Frequent neck US in papillary thyroid cancer likely detects non-actionable findings Journal Article
| Authors: | Sek, K. S. Y.; Tsang, I.; Lee, X. Y.; Albaqmi, O. H.; Allo, Y. J. M.; Rosmarin, M. C.; Mahrous, A. K.; Parameswaran, R.; Ng, D. C. E.; Tong, A. K. T.; Loke, K. S. H.; Brenta, G.; Alghamdi, A. H.; Albati, N. A.; Fish, S. A.; Tuttle, R. M.; Yang, S. P. |
| Article Title: | Frequent neck US in papillary thyroid cancer likely detects non-actionable findings |
| Abstract: | Background: American Thyroid Association (ATA) low-intermediate-risk papillary thyroid cancer (PTC) patients without structural and biochemical evidence of disease on initial post-treatment evaluation have a low risk of recurrence. Studies have shown that with current ultrasound scans (US) and thyroglobulin assays, recurrences mostly occurred 2-8 years after initial therapy. The ATA recommends that neck US be done 6-12 months after surgery to establish patient's response to therapy, then periodically depending on risk of recurrence. The lack of clarity in recommendations on timing of follow-up US and fear of recurrence leads to frequent tests. Objectives: To evaluate the utility of routine neck US in ATA low-intermediate-risk PTC patients with no structural disease on neck US and non-stimulated thyroglobulin <1.0 ng/mL after initial therapy. Methods: A retrospective study of 93 patients from Singapore, Saudi Arabia and Argentina with ATA low (n = 49) to intermediate (n = 44) risk PTC was conducted between 1998 and 2017. The outcome was to measure the frequency of identifying structural disease recurrence and non-actionable US abnormalities. Results: Over a median follow-up of 5 years, five of the 93 patients (5.4%) developed structural neck recurrence on US at a median of 2.5 years after initial treatment. Indeterminate US abnormalities were detected in 19 of the 93 patients (20.4%) leading to additional tests, which did not detect significant disease. Conclusion: In ATA low-intermediate-risk PTC with no suspicious findings on neck US and a non-stimulated thyroglobulin of <1.0 ng/mL after initial therapy, frequent US is more likely to identify non-actionable abnormalities than clinically significant disease. © 2020 John Wiley & Sons Ltd |
| Keywords: | recurrence; surveillance; low to intermediate risk; ultrasound scans |
| Journal Title: | Clinical Endocrinology |
| Volume: | 94 |
| Issue: | 3 |
| ISSN: | 0300-0664 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2021-03-01 |
| Start Page: | 504 |
| End Page: | 512 |
| Language: | English |
| DOI: | 10.1111/cen.14325 |
| PUBMED: | 32886805 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 April 2021 -- Source: Scopus |
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