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Thyroid Biology and Disease

MON-419 - Dynamic Risk Stratification and Early Thyroglobulin Kinetics as Predictors of Outcome in Ablated Differentiated Thyroid Cancer: A Latin American Cohort Study

Monday, June 15, 2026
9:00 AM - 2:00 PM CT
Location: ENDOExpo; Poster Floor

    Abstract Poster Presenter(s)

  • FY

    Fernanda Yanez, MD

    Physician
    University of Guayaquil, Ecuador
    Guayaquil, Guayas, Ecuador

    • Senior Author/Primary Investigator(s)

  • FY

    Fernanda Yanez, MD

    Physician
    University of Guayaquil, Ecuador
    Guayaquil, Guayas, Ecuador

  • MA

    Margarita Amaya, MD

    Physician
    National Autonomous University of Honduras
    San Pedro Sula, Cortes, Honduras

    • Co-Author(s)

  • SR

    Sendy Ruiz, MD

    Physician
    Catholic University of Honduras
    San Pedro Sula, Cortes, Honduras

  • AZ

    Alanna Zorrilla, MD

    Physician
    National University Pedro Henríquez Ureña, Dominican Republic
    Santo Domingo, Dominican Republic

    • Senior Author/Primary Investigator(s)

  • MA

    Maria Alvarado, MD

    Physician
    University of Guayaquil, Ecuador
    Guayaquil, Guayas, Ecuador

    • Co-Author(s)

  • LC

    Lillybeth Cervantes-Mallampati, MD

    Physician
    Autonomous University of Guadalajara, Jalisco Mexico
    Jalisco, Mexico

  • CM

    Carmen Mansilla, MD

    University of San Martín de Porres , Lima, Peru
    Lima, Peru

  • AT

    Andrea Tobar, MD

    Physician
    Pontifical Catholic University of Ecuador
    Quito, Pichincha, Ecuador

Background
Differentiated thyroid carcinoma (DTC) is the most common endocrine malignancy, with low disease-specific mortality; however, 5–24% of patients experience persistent or recurrent disease despite surgery and radioactive iodine (I-131) therapy [1]. Dynamic risk stratification (DRS) using longitudinal thyroglobulin (Tg) improves recurrence prediction [2,3]. Data from Latin America are limited; therefore, we evaluated American Thyroid Association (ATA)–guided DRS and early Tg kinetics in an Ecuadorian cohort.

Methods
We conducted a retrospective cohort study of patients with differentiated thyroid carcinoma treated with total thyroidectomy and I-131 ablation at Hospital Teodoro Maldonado, Guayaquil, Ecuador (2015–2019). Of 426 screened patients, 208 met inclusion criteria. Clinical data were obtained from outpatient endocrinology records. Follow-up used ATA-guided dynamic risk stratification with serial Tg measurements at 3, 6, 12, 24 months post-ablation.

Results
Among the 208 included patients, 78.8% (n =164) were female and 21.2% (n = 44) were male. Most patients were aged ≥ 45 years 73.6% , while 26.4% were younger than 45 years, and a mean age of 53.8 ± 14.1. Histologically, 95.7% had papillary thyroid carcinoma, followed by follicular carcinoma 4.3%. According to initial ATA risk stratification, 39.9% were low risk, 36.5% intermediate risk, and 21.6% high risk. At 6 months post-ablation, 59.1% of patients had unstimulated Tg < 1 ng/mL, increasing to 66.3% at 12 months. Patients with Tg ≥1 ng/mL at 6 months had a significantly higher recurrence rate compared with those with Tg < 1 ng/mL (13% vs. 1%; OR = 21.35; p < 0.001). Over 24 months of follow-up, 84.1% achieved complete remission, 13.9% experienced recurrence, and 1.9% developed metastases. Dynamic risk stratification demonstrated significant reclassification over time, with excellent response increasing from 56.7% to 74.5% at 24 months (p = 0.0002), while biochemically incomplete responses declined accordingly.

Conclusion
Early non-stimulated thyroglobulin levels ≥1 ng/mL were strongly associated with disease recurrence. Dynamic risk stratification allowed meaningful reclassification of patients during follow-up and improved individualized risk assessment. Incorporation of DRS into routine post-treatment surveillance may optimize follow-up strategies and reduce overtreatment in patients with favorable response profiles.

References
1. Hatipoğlu F, et al. Recurrence incidence in differentiated thyroid cancer. Mol Imaging Radionucl Ther. 2016;25(2):85‑90.
2. Pérez-Fernández L, et al. Dynamic risk stratification and BRAF in thyroid cancer. Front Endocrinol (Lausanne). 2023;13:1071775.
3. Fernández-Velasco P, et al. High-sensitive Tg and dynamic risk stratification. Endocrine. 2023;81(1):116‑122.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*