Risk-Stratified Outcomes Using the 2025 ATA Thyroglobulin Cutoff After Total Thyroidectomy in Differentiated Thyroid Cancer

Clicks: 19
ID: 332248
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #189 of 449 articles by views in the journal of clinical endocrinology & metabolism

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 449 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
BACKGROUND: Differentiated thyroid cancer (DTC) is increasingly managed with total thyroidectomy (TT) without radioactive iodine (RAI). An unstimulated thyroglobulin (Tg) ≤ 0.2 ng/mL has traditionally defined remission. The 2025 American Thyroid Association (ATA) guideline raised the threshold to 2.5 ng/mL to reduce overtreatment. We evaluated the performance of this cutoff in clinical practice. METHODS: We performed a retrospective study of patients with DTC treated with TT without RAI between 2001 and 2023. Eligible patients had more than 3 years of follow-up, undetectable anti-thyroglobulin antibody, and negative initial imaging. RESULTS: Of 2,781 screened patients, 205 met inclusion criteria: 118 were ATA low-, 42 low-intermediate, and 45 intermediate-high risk disease. Mean follow-up was 85 months. Using the revised Tg threshold (<2.5 ng/mL) increased the excellent response group from 76% to 98%. Among ATA low-risk patients, no structural recurrences were missed. However, 3.5% of patients with low-intermediate or higher-risk disease developed structural recurrence despite meeting excellent response criteria. The median time to recurrence was 22 months. In these patients, a postoperative Tg cutoff of 0.3 ng/mL demonstrated 100% sensitivity for structural recurrence. No thyroid cancer-related deaths occurred. CONCLUSIONS: The 2025 ATA Tg threshold increased excellent response classification without missing recurrence in low-risk patients. However, structural recurrences occurred in patients with higher-risk disease below the revised cutoff, suggesting that Tg thresholds may require risk-adapted interpretation. Continued imaging surveillance remains important for patients with low-intermediate or higher recurrence risk, even when Tg criteria for excellent response are met under the 2025 ATA guidelines.
Reference Key
openalex_W7221599710 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Mayumi Endo, Kulsum Madani, Tran Danielle, Christophe Courtine, Riya Yerramilli, Irina Azaryan, Andrew N. Hoofnagle, Mara Y Roth
Are you one of these authors? Claim your profile
Journal the journal of clinical endocrinology & metabolism
Year 2026
DOI
10.1210/clinem/dgag425
URL
https://doi.org/10.1210/clinem/dgag425
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.