Abstract

BackgroundThyroid cancer has an overall favorable prognosis, but no pre-operative biochemical marker has been shown to distinguish between low and high-risk disease or predict response to therapy. MethodsWe retrospectively reviewed 162 patients that underwent thyroid surgery for thyroid cancer between 2006-2022 in whom a pre-operative thyroglobulin level (Tg) was measured. We subdivided patients into low, intermediate and high-risk thyroid cancer and based on their response to therapy per ATA guidelines ResultsWe showed that as pre-operative Tg level increased, patients were more likely to have high-risk disease (p < 0.01). We found a linear association between the primary tumor size and high-risk histology with pre-operative Tg (p < 0.01). Pre-operative Tg level was significantly associated with response to therapy following initial surgical management. Specifically, as pre-operative Tg increases, patients were less likely to achieve an excellent response (p < 0.01). ConclusionsOur retrospective analysis demonstrated that pre-operative Tg is significantly associated with ATA structural risk of recurrence and response to therapy and may have the potential to guide initial therapy and follow-up management.

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