TOPLINE: 

Postoperative thyroglobulin levels > 1.05 μg/L independently predicted the recurrence of structural disease in patients with intermediate- and high-risk differentiated thyroid cancer (DTC), according to a retrospective study.

METHODOLOGY:

• Researchers analysed data of 301 patients with DTC (median age, 48 years; 69% women) who received radioactive iodine ablation therapy across three major cancer centres in the UK between January 2020 and December 2021.
• Postoperative thyroglobulin levels were measured 2-8 weeks after surgery, and patients were followed up for 2.5-3.5 years.
• The relationship between postoperative levels of unstimulated thyroglobulin and recurrence or persistence of structural disease was evaluated.

TAKEAWAY:

• Postoperative levels of unstimulated thyroglobulin emerged as an independent predictor of recurrence or persistence of structural disease (odds ratio, 1.016; P = .011).
• Receiver operating characteristic curve analysis revealed an area under the curve of 0.817 (P < .001) for postoperative thyroglobulin levels.
• A thyroglobulin cutoff value of 1.05 μg/L had 100% sensitivity and 22.9% specificity for predicting disease recurrence.
• Among the 21 patients with recurrent or persistent disease, 81% had postoperative thyroglobulin levels > 1.05 μg/L.

IN PRACTICE:

The authors wrote, "Low postoperative unstimulated Tg [thyroglobulin] level is associated with a low risk of structural disease in patients with intermediate- to high-risk DTC who received RAI [radioactive iodine] ablation following thyroidectomy." They added, "the prognostic value of postoperative Tg may be a promising addition to current risk-based approaches to stratify patients who may or may not benefit from RAI ablation"; however, "confirmatory prospective clinical trials are required to answer this question."

SOURCE:

The study was led by Leslie Cheng, The Royal Marsden NHS Foundation Trust, London, England, and Maciej Gajda, Weston Park Cancer Centre, Sheffield, England. It was published online on December 11, 2025, in Clinical Oncology.

LIMITATIONS:

The retrospective nature of the study introduced potential confounding and bias. Because all patients received radioactive iodine ablation, the researchers could not make definitive conclusions about omitting this treatment based solely on thyroglobulin levels. The recurrence rate was relatively low, necessitating cautious interpretation of the multiple logistic regression analysis. The exact dates when postoperative thyroglobulin levels were measured were not recorded.

DISCLOSURES:

This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sector. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.