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South African Journal of Surgery

On-line version ISSN 2078-5151
Print version ISSN 0038-2361

S. Afr. j. surg. vol.49 n.3 Cape Town Aug. 2011




Thyroglobulin - what is the postoperative threshold for the suspicion of thyroid cancer recurrence in the absence of anti-Tg antibody measurement?



M. S. PapageorgiouI; N. LiratzopoulosII; G. MinopoulosII; K. J. ManolasII

IM.D., Ph.D; Ist Department of Surgery, University General Hospital of Alexandroupolis, Greece
IIProfessor Of SURGERY; Ist Department of Surgery, University General Hospital of Alexandroupolis, Greece




BACKGROUND: Thyroglobulin (Tg) is used as a postoperative marker for the follow-up of patients with thyroid carcinoma, but there is no consensus regarding the value that may indicate possible recurrence.
AIM: To evaluate Tg levels as a marker for recurrence of thyroid carcinoma.
SUBJECTS AND METHODS: Demographics and survival of 80 patients who underwent total thyroidectomy for well-differentiated thyroid cancer were analysed and related to Tg levels. Tg measurements were performed when patients were euthyroid, after completion of treatment.
RESULTS: The median Tg value was 1.3 ng/ml. Higher values were found in males, high-risk patients and patients with recurrent disease. Using the median Tg value as cut-off, patients were divided into two groups (group I <1.3 ng/ml and group II >1.3 ng/ml). There was a significant correlation between values >1.3 ng/ml and recurrence. When survival was related to Tg values, there was a tendency towards worse prognosis in group II. The best predictive cut-off value for recurrence was found to be 1.3 ng/ml, which had a sensitivity of 77% and a specificity of 57%.
CONCLUSIONS: Although low, a cut-off Tg level of 1.3 ng/ml represents a simple indication for further investigation in patients receiving thyroxine after completion of treatment for thyroid cancer, in the absence of measurement of anti-Tg auto-antibodies.



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Adding smiles to children’s lives

Twenty children underwent reconstructive surgery during the ‘Adding Smiles to Life with Adcock Ingram’ Smile Week held from 25 to 29 July at Red Cross Hospital War Memorial Children’s Hospital, Cape Town. Thanks to the Smile Foundation and Adcock Ingram Healthcare, these children’s parents, families and communities can ‘celebrate the fact that they have a beautiful smile and can go off to school when they’re older without fear of being teased or isolated’, said Moira Gerszt, Chief Operating Officer of the Smile Foundation.

The Smile Foundation’s partnership with Adcock Ingram began last year. ‘Adcock Ingram is humbled by being part of this philanthropic initiative,’ said Dr Jonathan Louw, CEO for Adcock Ingram Healthcare.

‘The funding that Adcock Ingram contributes towards these life-changing operations not only lessens the deformity of these children, but ensures that the every child is able to swallow both solids and liquids with ease. Our partnership with Smile Foundation reiterates our commitment to adding value to life, and changing one child at a time,’ said Louw.

The Smile Foundation has partnered with academic hospitals in South Africa to help underprivileged children with facial conditions, alleviating backlogs in the hospitals, encouraging skills transfer, offering psychological help before and after surgery, and supporting hospital infrastructure.

The Smile Foundation’s partnership with Red Cross Children’s Hospital is now in its second year. As part of the partnership the Smile Foundation funds the additional resources necessary and pays for the surgery. The hospital provides the infrastructure, staff, care, treatment and expertise.

The success of the Smile Week model has been widespread. To date almost 700 children around the country have benefited from surgery through the partnership with state academic hospitals. In the Western Cape, 80 children have been helped during the various Smile Weeks held in the province.

For more information, contact Sanri van
Wyk, Taryn Fritz Public Relations.

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