Abstract
Background Radioactive iodine (RAI) ablation is recommended for most patients with differentiated thyroid carcinoma (DTC) after total thyroidectomy (TT). We aimed to compare long-term outcomes between intermediate-dose (100 mCi) and high-dose (150 mCi) RAI ablation therapy in patients with DTC using propensity score matching analysis. Methods This was a retrospective study of 1448 patients with DTC who underwent RAI ablation after TT. Propensity score matching was performed using the extent of operation, tumor size, extrathyroidal extension, multifocality, lymphatic invasion, vascular invasion, perineural invasion, number of positive lymph nodes (LNs), ATA risk stratification system, T stage, N stage, TNM stage, preoperative serum Tg and TgAb levels, and post-RAI serum Tg and TgAb levels. Results Recurrence rates in the intermediate- and high-dose groups were 3.1% and 5.6%, respectively. After propensity score matching, LN ratio >0.22 (HR, 2.915; 95% CI, 1.228–6.918; p=0.015) and serum Tg >10 ng/mL after RAI (HR, 3.976; 95% CI, 1.839–8.595; p < 0.001) were significant predictors of recurrence. Kaplan–Meier analysis showed no significant difference in DFS before or after propensity score matching (p=0.074 and p=0.378, respectively). Conclusions Intermediate-dose RAI ablation for the adjuvant treatment of DTC is sufficient as compared to high-dose RAI ablation. Further prospective or multicenter studies should be conducted to clarify the prognosis of intermediate-dose RAI ablation.
Highlights
Differentiated thyroid carcinoma (DTC) is the most frequent endocrine malignancy
Papillary thyroid carcinoma (PTC) is the most common form of differentiated thyroid carcinoma (DTC) and accounts for 90% of all thyroid malignancies, and the second most common form of DTC in Korea is follicular thyroid carcinoma (FTC) [4]. e development of diagnostic techniques and early screening has led to an increase in the diagnosis of papillary microcarcinoma [5, 6]
We retrospectively reviewed the medical records of 1539 patients with DTC who underwent Radioactive iodine (RAI) ablation after TT and/or modified radical neck dissection from January 2009 to December 2014 at Seoul St
Summary
Radioactive iodine (RAI) ablation is recommended for most patients with differentiated thyroid carcinoma (DTC) after total thyroidectomy (TT). We aimed to compare long-term outcomes between intermediate-dose (100 mCi) and high-dose (150 mCi) RAI ablation therapy in patients with DTC using propensity score matching analysis. Is was a retrospective study of 1448 patients with DTC who underwent RAI ablation after TT. Recurrence rates in the intermediate- and high-dose groups were 3.1% and 5.6%, respectively. LN ratio >0.22 (HR, 2.915; 95% CI, 1.228–6.918; p 0.015) and serum Tg >10 ng/mL after RAI (HR, 3.976; 95% CI, 1.839–8.595; p < 0.001) were significant predictors of recurrence. Kaplan–Meier analysis showed no significant difference in DFS before or after propensity score matching (p 0.074 and p 0.378, respectively). Intermediate-dose RAI ablation for the adjuvant treatment of DTC is sufficient as compared to high-dose RAI ablation. Further prospective or multicenter studies should be conducted to clarify the prognosis of intermediate-dose RAI ablation
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