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Frequent neck US in papillary thyroid cancer likely detects non‐actionable findings
Author(s) -
Sek Kathleen SuYen,
Tsang Ingrid,
Lee Xuan Yong,
Albaqmi Omar H.,
Morosan Allo Yanina Jimena,
Rosmarin Melanie Cinthia,
Mahrous Azhar K.,
Parameswaran Rajeev,
Ng David Chee Eng,
Tong Aaron Kian Ti,
Loke Kelvin Siu Hoong,
Brenta Gabriela,
Alghamdi Abdullah Hassan,
Albati Naif A.,
Fish Stephanie A.,
Tuttle R. Michael,
Yang Samantha Peiling
Publication year - 2021
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.14325
Subject(s) - medicine , thyroglobulin , papillary thyroid cancer , thyroid cancer , retrospective cohort study , disease , thyroid , thyroidectomy , thyroid carcinoma , cancer , oncology , radiology
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.