{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:59:07Z","timestamp":1792799947314,"version":"4.5.0"},"reference-count":24,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Korean Thyroid Association","award":["Clinical Research Award 2024"],"award-info":[{"award-number":["Clinical Research Award 2024"]}]},{"name":"Patient-Centered Clinical Research Coordinating Center funded by the Ministry of Health & Welfare, Republic of Korea","award":["RS-2024-00398702"],"award-info":[{"award-number":["RS-2024-00398702"]}],"id":[{"id":"https:\/\/ror.org\/00vxgjw72","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:sec>\n                    <jats:title>\n                      <jats:italic toggle=\"yes\">Background<\/jats:italic>\n                      :\n                    <\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\"\/>\n                      The prognostic value of unstimulated serum thyroglobulin (Tg) levels for structural recurrence in patients with low- to intermediate-risk differentiated thyroid cancer (DTC) who underwent total thyroidectomy but did not receive radioactive iodine (RAI) therapy remains unclear. This study aimed to determine Tg cutoff values and evaluate the role of dynamic Tg monitoring in risk stratification in these patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\"\/>\n                      We retrospectively analyzed 9753 patients with low- to intermediate-risk DTC who underwent total thyroidectomy without RAI at 11 Korean tertiary hospitals. Serum Tg levels were measured under thyrotropin suppression (&lt;2 mIU\/L) at 6, 12, and 24 months postoperatively using high-sensitive assays (functional sensitivity, &lt;0.2 ng\/mL). Optimal Tg cutoffs were determined by receiver operating characteristic curves and survival analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\"\/>\n                      Higher postoperative unstimulated Tg levels consistently predicted structural recurrence, with an optimal cutoff of 0.3 ng\/mL (area under the curve: 0.815, 0.772, and 0.816 at 6, 12, and 24 months, respectively). A Tg \u2265 0.2 ng\/mL, the Korean Thyroid Association (KTA) guideline cutoff for biochemical remission (excellent response), showed high sensitivity for recurrence. Tg \u2265 5.0 ng\/mL at 6 months, a KTA-defined threshold for a biochemical incomplete response, independently predicted an elevated recurrence risk. Kaplan\u2013Meier curves showed stepwise declines in recurrence-free survival with increasing Tg levels. Notably, even Tg &lt; 0.2 or &lt; 0.3 ng\/mL were associated with recurrence if levels rose over time.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\"\/>\n                      Unstimulated Tg levels are strongly associated with the risk of structural recurrence in patients with DTC who have undergone total thyroidectomy without RAI. The current cutoff values of 0.2 ng\/mL and 5.0 ng\/mL were clinically relevant, and Tg kinetics over time further improved risk stratification. These findings provide the first large-scale evidence from an East Asian cohort and underscore the importance of early, serial Tg assessment in this growing patient population.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10507256251409134","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T15:53:32Z","timestamp":1767110012000},"page":"46-56","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Thyroglobulin Cutoffs after Total Thyroidectomy Without Radioiodine in Low- to Intermediate-Risk Thyroid Cancer: A Multicenter Cohort Study"],"prefix":"10.1177","volume":"36","author":[{"given":"Mijin","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Kyung","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Center for Thyroid Cancer, National Cancer Center, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyeong Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soo Myoung","family":"Shin","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinsun","family":"Jang","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Center for Thyroid Cancer, National Cancer Center, Republic of Korea."},{"name":"Department of Translational Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Je Yoon","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meihua","family":"Jin","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ja Seong","family":"Bae","sequence":"additional","affiliation":[{"name":"Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwangsoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won Gu","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Ji","family":"Jeon","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Heon","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head and Neck Surgery, Chungbuk National University College of Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hee Kyung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jee Hee","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yea Eun","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Chungnam National University, Daejeon, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hwa Young","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Joo","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea."},{"name":"Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea."},{"name":"Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of 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