About this Journal Submit a Manuscript Table of Contents
Journal of Thyroid Research
Volume 2012 (2012), Article ID 481568, 8 pages
http://dx.doi.org/10.1155/2012/481568
Research Article

Radioiodine Thyroid Remnant Ablation after Recombinant Human Thyrotropin or Thyroid Hormone Withdrawal in Patients with High-Risk Differentiated Thyroid Cancer

1Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, Córdoba 2351, 5th Floor, Buenos Aires 1424, Argentina
2Division of Medical Editing, Spencer-Fontayne Corporation, 33 Bentley Avenue, Jersey City, NJ 07304-1901, USA
3Division of Endocrinology, Hospital Churruca Visca, Uspallata 3400, Buenos Aires 1437, Argentina
4Division of Endocrinology, Consultorios Integrados Rosario, Italia 424, Santa Fe, Rosario 2000, Argentina

Received 16 August 2012; Accepted 17 October 2012

Academic Editor: Daniele Barbaro

Copyright © 2012 Fabián Pitoia et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

To supplement limited relevant literature, we retrospectively compared ablation and disease outcomes in high-risk differentiated thyroid carcinoma (DTC) patients undergoing radioiodine thyroid remnant ablation aided by recombinant human thyrotropin (rhTSH) versus thyroid hormone withdrawal/withholding (THW). Our cohort was 45 consecutive antithyroglobulin antibody- (TgAb-) negative, T3-T4/N0-N1-Nx/M0 adults ablated with high activities at three referral centers. Ablation success comprised negative (<1 μg/L) stimulated serum thyroglobulin (Tg) and TgAb, with absent or <0.1% scintigraphic thyroid bed uptake. “No evidence of disease” (NED) comprised negative unstimulated/stimulated Tg and no suspicious neck ultrasonography or pathological imaging or biopsy. “Persistent disease” was failure to achieve NED, “recurrence,” loss of NED status. rhTSH patients ( ) were oftener ≥45 years old and higher stage ( ), but otherwise not different than THW patients ( ) at baseline. rhTSH patients were significantly oftener successfully ablated compared to THW patients (83% versus 67%, ). After respective 3.3 yr and 4.5 yr mean follow-ups ( ), NED was achieved oftener (72% versus 59%) and persistent disease was less frequent in rhTSH patients (22% versus 33%) (both comparisons ). rhTSH stimulation is associated with at least as good outcomes as is THW in ablation of high-risk DTC patients.