Thyroglobulin test at 3 weeks after surgery in well-differentiated thyroid cancer and its predictive value: the role of endocrine-metabolic status

Aim & methods: The present pilot study included 50 differentiated thyroid cancer (DTC) patients (mean age: 45.8 +/- 1.8 years, range: 18-73 years) who were followed after surgery for in average 30.0 +/- 2.6 months. All patients were subdivided into two groups as having either <2 ng/ml or >= 2 ng/ml blood thyroglobulin level 3 weeks after the operation (3-WTT). Results: Subsequent tumor progression was revealed more often in patients with higher thyroglobulinemia (>= 2 ng/ml) in both low-and high-risk DTC groups. Patients with high-risk DTC and 3-week thyroglobulin levels >= 2 ng/ml were more likely to have a higher pre-surgical thyrotropin (TSH) levels. On the contrary, patients with low-risk DTC and 3-week thyroglobulin level >= 2 ng/ml demonstrated tendency to higher preoperative serum insulin levels and higher BMI. Conclusion: These differential findings could suggest that, whereas maximal suppression of TSH is reasonable in high-risk DTC patients, in low-risk DTC patients, for whom this is not justified, a moderate TSH suppression supplemented by multivalent drugs, such as antidiabetic biguanide metformin, could be advised.