Follow-Up of Low Risk Patients with Papillary Thyroid Cancer: Role of Neck Ultrasonography in Detecting Lymph Node Metastases

• DOI: 10.1210/jc.2003-031521
• Publication Date: 2004-07-07T13:44:07Z
• Authors: Massimo Torlontano; Marco Attard; Umberto Crocetti; Salvatore Tumino; Rocco Bruno; Giuseppe Costante; Girolamo D’Azzò; Domenico Meringolo; Elisabetta Ferretti; Rosario Sacco; Franco Arturi; Sebastiano Filetti
• Keywords: Adult; Male; Adolescent; Biopsy; Sensitivity and Specificity; Thyroglobulin; Carcinoma, Papillary; Drug Administration Schedule; 3. Good health; Cohort Studies; Iodine Radioisotopes; 03 medical and health sciences; 0302 clinical medicine; Predictive Value of Tests; Risk Factors; Lymphatic Metastasis; Humans; Female; Lymph Nodes; Thyroid Neoplasms; Neoplasm Recurrence, Local; Neck; Follow-Up Studies

Persistent or recurrent disease is rare in low risk patients with papillary thyroid cancer, and follow-up of these a matter debate. Neck ultrasonography (US), serum thyroglobulin (Tg), whole body scan (WBS) after T4 withdrawal were performed 456 patients, followed up to 5 yr. At the end first year, 335 Tg negative, 121 positive; 65 96 levels between 1 10 ng/ml became spontaneously negative 2 During follow-up, WBS discovered node metastases 13 subjects, US 38 subjects (31 positive 7 negative). did not add any information, because all WBS-positive also positive. Fifty percent less than cm palpable. Finally, predictive value both at was 98.8%. We suggest based upon assessment stimulated (after recombinant human TSH) determination; subsequently, 1) should be mandatory each examination initially Tg- US-negative but strongly suggested other cases; 2) determination repeated yr later, exogenous endogenous TSH stimulation only Tg-positive without evidence residual disease; 3) measurement during therapy sufficient cases.