The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Michael R Tuttle - One of the best experts on this subject based on the ideXlab platform.
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controversies consensus and collaboration in the use of 131 i therapy in Differentiated Thyroid Cancer a joint statement from the american Thyroid association the european association of nuclear medicine the society of nuclear medicine and molecular
Thyroid, 2019Co-Authors: Michael R Tuttle, Anca M Avram, Sukhjeet Ahuja, Victor Bernet, P Bourguet, Gilbert H Daniels, Gary Dillehay, Ciprian Draganescu, Glenn D Flux, Dagmar FuhrerAbstract:Background: Publication of the 2015 American Thyroid Association (ATA) management guidelines for adult patients with Thyroid nodules and Differentiated Thyroid Cancer was met with disagreement by t...
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using the american Thyroid association risk stratification system to refine and individualize the american joint committee on Cancer eighth edition disease specific survival estimates in Differentiated Thyroid Cancer
Thyroid, 2018Co-Authors: Sana A Ghaznavi, Ian Ganly, Ashok R Shaha, Crystal English, Jonathan Wills, Michael R TuttleAbstract:Background: The eighth edition of the American Joint Committee on Cancer (AJCC) staging system has reclassified up to one third of Differentiated Thyroid Cancer patients into one of the younger pro...
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novel concepts for initiating multitargeted kinase inhibitors in radioactive iodine refractory Differentiated Thyroid Cancer
Best Practice & Research Clinical Endocrinology & Metabolism, 2017Co-Authors: Michael R Tuttle, Marcia S Brose, Makoto Tahara, Enrique Grande, Sun Wook Kim, Mona M SabraAbstract:Multitargeted kinase inhibitors have been shown to improve progression-free survival in patients with structurally progressive, radioactive iodine refractory Differentiated Thyroid Cancer. While the inclusion criteria for phase 3 clinical trials and clinical practice guidelines provide guidance with regard to the minimal requirements that need to be met prior to initiation of a multitargeted kinase inhibitor, a better way to integrate the rate of structural disease progression with the size of the metastatic foci to more precisely define the optimal time to recommend initiation of therapy for individual patients is needed. In this manuscript we describe how to use assessments of tumor size and growth rates (structural disease doubling times) to define the critical point in time when the volume and rate of progression of metastatic structural disease merits consideration for initiation of systemic therapy (the inflection point).
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previous external beam radiation treatment exposure does not confer worse outcome for patients with Differentiated Thyroid Cancer
Thyroid, 2017Co-Authors: Manish Shaha, Ashok R Shaha, Michael R Tuttle, Jatin P Shah, Iain J Nixon, Frank L Palmer, Snehal G Patel, Laura Y Wang, Jocelyn C Migliacci, Ian GanlyAbstract:Background: Radiation exposure, especially in childhood, is known to increase the risk for the development of Thyroid Cancer. However, the prognosis of patients with Thyroid Cancer with a history of radiation treatment exposure remains unclear. Methods: One hundred and sixteen patients with a previous history of radiotherapy in the head and neck region were identified from an institutional database of 3664 patients with Differentiated Thyroid Cancer treated between 1986 and 2010. Using the Kaplan–Meier method, disease-specific survival and recurrence-free survival were compared between patients with (RT; n = 116) and without (No RT; n = 3509) a prior history of radiation exposure. Results: The median ages of the RT and No RT cohorts were 52 and 47 years. The median follow-up for both groups was 54 months. Patients who had a prior history of radiation treatment exposure were more likely to be male (38.8% vs. 26.9%; p = 0.005) and older than 45 years of age (67.2% vs. 53.9%; p = 0.005). Other patient, tumor...
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external beam radiotherapy for Differentiated Thyroid Cancer locoregional control a statement of the american head and neck society
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2016Co-Authors: A P Kiess, Michael R Tuttle, James D Brierley, Nishant Agrawal, Umamaheswar Duvvuri, Robert L Ferris, Eric M Genden, Richard J Wong, Nancy Y Lee, Gregory W RandolphAbstract:The use of external-beam radiotherapy (EBRT) in Differentiated Thyroid Cancer (DTC) is debated because of a lack of prospective clinical data, but recent retrospective studies have reported benefits in selected patients. The Endocrine Surgery Committee of the American Head and Neck Society provides 4 recommendations regarding EBRT for locoregional control in DTC, based on review of literature and expert opinion of the authors. (1) EBRT is recommended for patients with gross residual or unresectable locoregional disease, except for patients 45 years old with high likelihood of microscopic residual disease and low likelihood of responding to RAI. (4) Cervical lymph node involvement alone should not be an indication for adjuvant EBRT.
David S Cooper - One of the best experts on this subject based on the ideXlab platform.
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reassessing the ntctcs staging systems for Differentiated Thyroid Cancer including age at diagnosis
Thyroid, 2015Co-Authors: David S Cooper, Bryan R Haugen, D S Mcleod, Jacqueline Jonklaas, James D Brierley, Kenneth B Ain, Henry G Fein, Paul W LadensonAbstract:Background: Thyroid Cancer is unique for having age as a staging variable. Recently, the commonly used age cut-point of 45 years has been questioned. Objective: This study assessed alternate staging systems on the outcome of overall survival, and compared these with current National Thyroid Cancer Treatment Cooperative Study (NTCTCS) staging systems for papillary and follicular Thyroid Cancer. Methods: A total of 4721 patients with Differentiated Thyroid Cancer were assessed. Five potential alternate staging systems were generated at age cut-points in five-year increments from 35 to 70 years, and tested for model discrimination (Harrell's C-statistic) and calibration (R2). The best five models for papillary and follicular Cancer were further tested with bootstrap resampling and significance testing for discrimination. Results: The best five alternate papillary Cancer systems had age cut-points of 45–50 years, with the highest scoring model using 50 years. No significant difference in C-statistic was found...
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low risk Differentiated Thyroid Cancer and radioiodine remnant ablation a systematic review of the literature
The Journal of Clinical Endocrinology and Metabolism, 2015Co-Authors: Livia Lamartina, Cosimo Durante, Sebastiano Filetti, David S CooperAbstract:Background: Radioiodine remnant ablation (RRA) has traditionally been one of the cornerstones of Differentiated Thyroid Cancer (DTC) treatment. The decision to use RRA in low-risk (LR) and intermediate-risk (IR) patients is controversial. The aim of this review is to examine the evidence of RRA benefit in the staging, follow-up, and recurrence prevention in LR and IR DTC patients. Methods: From a PubMed search, we selected original papers (OPs) using the following inclusion criteria: 1) DTC; 2) LR and IR patients; 3) non-RRA-treated patients or RRA-treated vs non-RRA-treated groups; 4) a report of the outcome of Cancer recurrence; and 5) publication since 2008. Results: Neck ultrasonography is superior to whole-body scan for disease detection in the neck. A rising or declining serum thyroglobulin level over time provides an excellent positive or negative predictive value, respectively, even in non-RRA-treated patients. No OP demonstrating RRA benefit on recurrence in LR patients was found; two OPs found n...
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prognosis of Differentiated Thyroid Cancer in relation to serum thyrotropin and thyroglobulin antibody status at time of diagnosis
Thyroid, 2014Co-Authors: David S Cooper, Bryan R Haugen, D S Mcleod, Jacqueline Jonklaas, James D Brierley, Kenneth B Ain, Henry G Fein, Paul W Ladenson, James MagnerAbstract:Background: Serum thyrotropin (TSH) concentration and Thyroid autoimmunity may be of prognostic importance in Differentiated Thyroid Cancer (DTC). Preoperative serum TSH level has been associated with higher DTC stage in cross-sectional studies; data are contradictory on the significance of Thyroid autoimmunity at the time of diagnosis. Objective: We sought to assess whether preoperative serum TSH and perioperative antithyroglobulin antibodies (TgAb) were associated with Thyroid Cancer stage and outcome in DTC patients followed by the National Thyroid Cancer Treatment Cooperative Study, a large multicenter Thyroid Cancer registry. Methods: Patients registered after 1996 with available preoperative serum TSH (n=617; the TSH cohort) or perioperative TgAb status (n=1770; the TgAb cohort) were analyzed for tumor stage, persistent disease, recurrence, and overall survival (OS; median follow-up, 5.5 years). Parametric tests assessed log-transformed TSH, and categorical variables were tested with chi square. Dis...
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benefits of thyrotropin suppression versus the risks of adverse effects in Differentiated Thyroid Cancer
Thyroid, 2010Co-Authors: Bernadette Biondi, David S CooperAbstract:Background: Despite clinical practice guidelines for the management of Differentiated Thyroid Cancer (DTC), there are no recommendations on the optimal serum thyrotropin (TSH) concentration to reduce tumor recurrences and improve survival, while ensuring an optimal quality of life with minimal adverse effects. The aim of this review was to provide a risk-adapted management scheme for levothyroxine (L-T4) therapy in patients with DTC. The objective was to establish which patients require complete suppression of serum TSH levels, given their risk of recurrent or metastatic DTC, and how potential adverse effects on the heart and skeleton, induced by subclinical hyperThyroidism, in concert with advanced age and comorbidities, may influence the degree of TSH suppression. Summary: A risk-stratified approach to predict the rate of recurrence and death from Thyroid Cancer was based on the recently revised American Thyroid Association guidelines. A stratified approach to predict the risk from the adverse effects o...
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benefits of thyrotropin suppression versus the risks of adverse effects in Differentiated Thyroid Cancer
Thyroid, 2010Co-Authors: Bernadette Biondi, David S CooperAbstract:Background: Despite clinical practice guidelines for the management of Differentiated Thyroid Cancer (DTC), there are no recommendations on the optimal serum thyrotropin (TSH) concentration to redu...
Martin Schlumberger - One of the best experts on this subject based on the ideXlab platform.
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radioactive iodine refractory Differentiated Thyroid Cancer an uncommon but challenging situation
Archives of Endocrinology and Metabolism, 2017Co-Authors: Angelica Schmidt, Fabian Pitoia, Laura Iglesias, Michele Klain, Martin SchlumbergerAbstract:Radioiodine (RAI)-refractory Thyroid Cancer is an uncommon entity, occurring with an estimated incidence of 4-5 cases/year/million people. RAI refractoriness is more frequent in older patients, in those with large metastases, in poorly Differentiated Thyroid Cancer, and in those tumors with high 18-fluordeoxyglucose uptake on PET/CT. These patients have a 10-year survival rate of less than 10%. In recent years, new therapeutic agents with molecular targets have become available, with multikinase inhibitors (MKIs) being the most investigated drugs. Two of these compounds, sorafenib and lenvatinib, have shown significant objective response rates and have significantly improved the progression-free survival in the two largest published prospective trials on MKI use. However, no overall survival benefit has been achieved yet. This is probably related to the crossover that occurs in most patients who progress on placebo treatment to the open treatment of these studies. In consequence, the challenge is to correctly identify which patients will benefit from these treatments. It is also crucial to understand the appropriate timing to initiate MKI treatment and when to stop it. The purpose of this article is to define RAI refractoriness, to summarize which therapies are available for this condition, and to review how to select patients who are suitable for them.
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subgroup analysis of japanese patients in a phase 3 study of lenvatinib in radioiodine refractory Differentiated Thyroid Cancer
Cancer Science, 2015Co-Authors: Naomi Kiyota, Lori J Wirth, Steven I. Sherman, Martin Schlumberger, Shunji Takahashi, Bruce G Robinson, Kei Muro, Yuichi Ando, Yasukazu Kawai, Takuya SuzukiAbstract:Lenvatinib significantly prolonged progression-free survival (PFS) versus placebo in patients with radioiodine-refractory Differentiated Thyroid Cancer (RR-DTC) in the phase 3 Study of (E7080) Lenvatinib in Differentiated Cancer of the Thyroid (SELECT) trial. This subanalysis evaluated the efficacy and safety of lenvatinib in Japanese patients who participated in SELECT. Outcomes for Japanese patients (lenvatinib, n = 30; placebo, n = 10) were assessed in relationship to the SELECT population (lenvatinib, n = 261; placebo, n = 131). The primary endpoint was PFS; secondary endpoints included overall survival, overall response rate, and safety. Lenvatinib PFS benefit was shown in Japanese patients (median PFS: lenvatinib, 16.5 months; placebo, 3.7 months), although significance was not reached, presumably due to sample size (hazard ratio, 0.39; 95% confidence interval, 0.10-1.57; P = 0.067). Overall response rates were 63.3% and 0% for lenvatinib and placebo, respectively. No significant difference was found in overall survival. The lenvatinib safety profile was similar between the Japanese and overall SELECT population, except for higher incidences of hypertension (any grade: Japanese, 87%; overall, 68%; grade ≥3: Japanese, 80%; overall, 42%), palmar-plantar erythrodysesthesia syndrome (any grade: Japanese, 70%; overall, 32%; grade ≥3: Japanese, 3%; overall, 3%), and proteinuria (any grade: Japanese, 63%; overall, 31%; grade ≥3: Japanese, 20%; overall, 10%). Japanese patients had more dose reductions (Japanese, 90%; overall, 67.8%), but fewer discontinuations due to adverse events (Japanese, 3.3%; overall, 14.2%). There was no difference in lenvatinib exposure between the Japanese and overall SELECT populations after adjusting for body weight. In Japanese patients with radioiodine-refractory Differentiated Thyroid Cancer, lenvatinib showed similar clinical outcomes to the overall SELECT population. Some differences in adverse event frequencies and dose modifications were observed. Clinical trial registration no.: NCT01321554.
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revised american Thyroid association management guidelines for patients with Thyroid nodules and Differentiated Thyroid Cancer
Thyroid, 2009Co-Authors: David S Cooper, Furio Pacini, Bryan R Haugen, Gerard M Doherty, Susan J Mandel, Richard T Kloos, Stephanie Lee, Ernest L Mazzaferri, Bryan Mciver, Martin SchlumbergerAbstract:Background: Thyroid nodules are a common clinical problem, and Differentiated Thyroid Cancer is becoming increasingly prevalent. Since the publication of the American Thyroid Association's guidelines for the management of these disorders was published in 2006, a large amount of new information has become available, prompting a revision of the guidelines. Methods: Relevant articles through December 2008 were reviewed by the task force and categorized by topic and level of evidence according to a modified schema used by the United States Preventative Services Task Force. Results: The revised guidelines for the management of Thyroid nodules include recommendations regarding initial evaluation, clinical and ultrasound criteria for fine-needle aspiration biopsy, interpretation of fine-needle aspiration biopsy results, and management of benign Thyroid nodules. Recommendations regarding the initial management of Thyroid Cancer include those relating to optimal surgical management, radioiodine remnant ablation, a...
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2015 american Thyroid association management guidelines for adult patients with Thyroid nodules and Differentiated Thyroid Cancer the american Thyroid association guidelines task force on Thyroid nodules and Differentiated Thyroid Cancer
Thyroid, 2009Co-Authors: Bryan R Haugen, Furio Pacini, Gregory W Randolph, Erik K Alexander, Keith C Bible, Gerard M Doherty, Susan J Mandel, Yuri E Nikiforov, Anna M Sawka, Martin SchlumbergerAbstract:Background: Thyroid nodules are a common clinical problem, and Differentiated Thyroid Cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of Thyroid nodules and Differentiated Thyroid Cancer. Methods: The specific clinical questions addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of task force members. Task force panel members were educated on knowledge synthesis methods, including electronic database searching, review and selection of relevant citations, and critical appraisal of selected studies. Published English language articles on adults were eligible for inclusion. The American College of Physicians Guideline Gr...
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ultrasound criteria of malignancy for cervical lymph nodes in patients followed up for Differentiated Thyroid Cancer
The Journal of Clinical Endocrinology and Metabolism, 2007Co-Authors: S Leboulleux, E Girard, Mathieu Rose, Jean Paul Travagli, Nadia Sabbah, B Caillou, Dana M Hartl, N Lassau, Eric Baudin, Martin SchlumbergerAbstract:Context: Neck ultrasonography (US) has become a keystone in the follow-up of patients with Differentiated Thyroid Cancer. Objective: The aim of this study was to determine specificity and sensitivity of ultrasound criteria of malignancy for cervical lymph nodes (LNs) in patients with Differentiated Thyroid Cancer. Design: We prospectively studied 19 patients referred to the Institut Gustave Roussy for neck LN dissection. All patients underwent a neck US within 4 d prior to surgery. Only LNs that were unequivocally matched between US and pathology were taken into account for the analysis. Results: One hundred three LNs were detected on US, 578 LNs were surgically removed, and 56 LNs were analyzed (28 benign and 28 malignant). Sensitivity and specificity were 68 and 75% for the long axis (≥1 cm), 61 and 96% for the short axis (>5 mm), 46 and 64% for the round shape (long to short axis ratio < 2), 100 and 29% for the loss of fatty hyperechoic hilum, 39 and 18% for hypoechogenicity, 11 and 100% for cystic app...
Keith C Bible - One of the best experts on this subject based on the ideXlab platform.
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european perspective on 2015 american Thyroid association management guidelines for adult patients with Thyroid nodules and Differentiated Thyroid Cancer proceedings of an interactive international symposium
Thyroid, 2019Co-Authors: Markus Luster, Leonidas H Duntas, Rossella Elisei, Keith C Bible, Cumali Aktolun, Isabel Amendoeira, Marcin Barczynski, Daria Handkiewiczjunak, Martha Hoffmann, Barbara JarząbAbstract:Background: The American Thyroid Association (ATA) management guidelines for patients with Thyroid nodules and Differentiated Thyroid Cancer (DTC) are highly influential practice recommendations. T...
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advanced radioiodine refractory Differentiated Thyroid Cancer the sodium iodide symporter and other emerging therapeutic targets
The Lancet Diabetes & Endocrinology, 2014Co-Authors: Christine Spitzweg, Keith C Bible, Lorenz C Hofbauer, John C MorrisAbstract:Summary Approximately 30% of patients with advanced, metastatic Differentiated Thyroid Cancer have radioiodine-refractory disease, based on decreased expression of the sodium iodide symporter SLC5A5 (NIS), diminished membrane targeting of NIS, or both. Patients with radioiodine-refractory disease, therefore, are not amenable to 131 I therapy, which is the initial systemic treatment of choice for non-refractory metastatic Thyroid Cancer. Patients with radioiodine-refractory Cancer have historically had poor outcomes, partly because these Cancers often respond poorly to cytotoxic chemotherapy. In the past decade, however, considerable progress has been made in delineating the molecular pathogenesis of radioiodine-refractory Thyroid Cancer. As a result of the identification of key genetic and epigenetic alterations and dysregulated signalling pathways, multiple biologically targeted drugs, in particular tyrosine-kinase inhibitors, have been evaluated in clinical trials with promising results and have begun to meaningfully impact clinical practice. In this Review, we summarise the current knowledge of the molecular pathogenesis of advanced Differentiated Thyroid Cancer and discuss findings from clinical trials of targeted drugs in patients with radioiodine-refractory disease. Additionally, we focus on the molecular basis of loss of NIS expression, function, or both in refractory disease, and discuss preclinical and clinical data on restoration of radioiodine uptake.
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development and characterization of a Differentiated Thyroid Cancer cell line resistant to vegfr targeted kinase inhibitors
The Journal of Clinical Endocrinology and Metabolism, 2014Co-Authors: Crescent R Isham, Keith C Bible, Brian C Netzel, Ayoko R Bossou, Dragana Milosevic, Kendall W Cradic, Stefan K G GrebeAbstract:Background: Vascular endothelial growth factor-targeted kinase inhibitors have emerged as highly promising therapies for radioiodine-refractory metastatic Differentiated Thyroid Cancer. Unfortunately, drug resistance uniformly develops, limiting their therapeutic efficacies and thereby constituting a major clinical problem. Approach and Methods: To study acquired drug resistance and elucidate underlying mechanisms in this setting, BHP2–7 human Differentiated Thyroid Cancer cells were subjected to prolonged continuous in vitro selection with 18 μM pazopanib, a clinically relevant concentration; acquisition of pazopanib resistance was serially assessed, with the resulting resistant cells thereafter subcloned and characterized to assess potential mechanisms of acquired pazopanib resistance. Results: Stable 2- to 4-fold in vitro pazopanib resistance emerged in response to pazopanib selection associated with similar in vitro growth characteristics but with markedly more aggressive in vivo xenograft growth. Sel...
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2015 american Thyroid association management guidelines for adult patients with Thyroid nodules and Differentiated Thyroid Cancer the american Thyroid association guidelines task force on Thyroid nodules and Differentiated Thyroid Cancer
Thyroid, 2009Co-Authors: Bryan R Haugen, Furio Pacini, Gregory W Randolph, Erik K Alexander, Keith C Bible, Gerard M Doherty, Susan J Mandel, Yuri E Nikiforov, Anna M Sawka, Martin SchlumbergerAbstract:Background: Thyroid nodules are a common clinical problem, and Differentiated Thyroid Cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of Thyroid nodules and Differentiated Thyroid Cancer. Methods: The specific clinical questions addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of task force members. Task force panel members were educated on knowledge synthesis methods, including electronic database searching, review and selection of relevant citations, and critical appraisal of selected studies. Published English language articles on adults were eligible for inclusion. The American College of Physicians Guideline Gr...
Frederik A. Verburg - One of the best experts on this subject based on the ideXlab platform.
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low or undetectable basal thyroglobulin levels obviate the need for neck ultrasound in Differentiated Thyroid Cancer patients after total Thyroidectomy and 131i ablation
Thyroid, 2018Co-Authors: Frederik A. Verburg, Markus Luster, Uwe Mader, Luca Giovanella, Christoph ReinersAbstract:Background: Neck ultrasound (NUS) is currently seen as a main component of follow-up of Differentiated Thyroid Cancer (DTC) and is usually performed regardless of non-stimulated thyroglobulin (Tg) ...
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the tnm system version 7 is the most accurate staging system for the prediction of loss of life expectancy in Differentiated Thyroid Cancer
Clinical Endocrinology, 2016Co-Authors: Karina Tanase, Frederik A. Verburg, Uwe Mader, Christoph Reiners, Elenadaphne ThiesAbstract:OBJECTIVE Many prognostic systems have been developed for Differentiated Thyroid Cancer. It is unclear which one of these performs 'best'. Our aim was to compare staging systems applicable to our patient database to identify which best predicts DTC-related loss of life expectancy and DTC-specific mortality. DESIGN Database study of patients with DTC treated in our centre between 1978 (earliest available data) up to and including 1 July 2014. All were staged in accordance with the AMES, Clinical Class, Memorial Sloan Kettering, Ohio State University, TNM versions 5 and 6/7, University of Alabama, University of Munster and qTNM systems. PATIENTS A total of 2257 patients with Differentiated Thyroid Cancer. MEASUREMENTS Loss of life expectancy expressed as relative survival and Thyroid Cancer-specific mortality. Comparison was based on P values of univariate Cox regression analyses as well as analysis of the proportion of variance explained (PVE). RESULTS Median available follow-up time was 7·2 years (range: 0-35·1 years). Three hundred and twenty-seven patients died, 149 of whom died of DTC. Version 7 of the TNM system was best for predicting DTC-related mortality (P = 7·1 × 10-52 ; PVE = 0·296), followed by TNM version 5 (P = 6·7 × 10-44 ; PVE = 0·255). For prediction of loss of life expectancy, version 7 of the TNM system was also best, closely followed by the Clinical Class system (P both < 2 × 10-16 ). CONCLUSIONS The UICC/AJCC TNM system version 7 outperforms other prognostic classification systems based on extent of disease at the start of treatment both for prediction of Differentiated Thyroid Cancer-related death and for prediction of loss life expectancy.
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unstimulated highly sensitive thyroglobulin in follow up of Differentiated Thyroid Cancer patients a meta analysis
The Journal of Clinical Endocrinology and Metabolism, 2014Co-Authors: Luca Giovanella, Giorgio Treglia, Ramin Sadeghi, Pierpaolo Trimboli, Luca Ceriani, Frederik A. VerburgAbstract:Context: Serum thyroglobulin (Tg) is an indicator of Differentiated Thyroid Cancer (DTC) relapse. Objective: Our objective was to conduct a meta-analysis of published data about the diagnostic performance of highly sensitive serum Tg (hsTg) during levothyroxine therapy in DTC follow-up. Data Sources: We performed a comprehensive literature search of PubMed/MEDLINE and Scopus for studies published until July 2013. Study Selection: Studies investigating the diagnostic performance of basal hsTg in monitoring DTC were eligible. Exclusion criteria were 1) articles not within the field of interest; 2) reviews, letters, or conference proceedings; 3) articles evaluating serum Tg measurement with a functional sensitivity >0.1 ng/mL; 4) overlap in patient data; and 5) insufficient data to reassess diagnostic performance of basal serum hsTg. Data Extraction: Information was collected concerning basic study data, patient characteristics, and technical aspects. For each study, the number of true-positive, false-positi...
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implications of thyroglobulin antibody positivity in patients with Differentiated Thyroid Cancer a clinical position statement
Thyroid, 2013Co-Authors: Frederik A. Verburg, Markus Luster, Cristina Cupini, Luca Chiovato, Leonidas H Duntas, Rossella Elisei, Ulla Feldtrasmussen, Harald Rimmele, Ettore Seregni, Johannes W A SmitAbstract:Background: Even though the presence of antithyroglobulin antibodies (TgAbs) represents a significant problem in the follow-up of patients with Differentiated Thyroid Cancer (DTC), the current guidelines on the management of DTC that have been published in recent years contain no text concerning the methods to be used for detecting such antibody-related interference in thyroglobulin (Tg) measurement or how to manage TgAb-positive patients in whom Tg cannot be used reliably as a tumor marker. Aim: An international group of experts from the European Thyroid Association Cancer Research Network who are involved in the care of DTC patients met twice to form a consensus opinion on how to proceed with treatment and follow-up in TgAb-positive DTC patients based on the available evidence in the literature. Here we will report on the consensus opinions that were reached regarding technical and clinical issues. Results: This clinical opinion article provides an overview of the available evidence and the resulting co...