Abstract
Objective: To investigate whether the factors related to the patient and the disease have any effect on the success of ablation therapy in patients with differentiated thyroid cancer who have received I-131 ablation therapy.Material and Methods: All the patients with differentiated thyroid cancer were referred for I-131 ablation therapy after thyroidectomy between July 2007 and September 2009. The patients had at least six months of follow-up. Age, gender, type of tumor, presence of capsule invasion, size of tumor, number of the tumors, localization of the tumor, invasion of thyroid capsule, lymph/vessel invasion, presence of metastatic lymph nodes, type of surgery, preablation values of thyroglobulin (Tg), AntiTg, TSH, surveys for the evaluation of metastatic disease, (thyroid and bone scintigraphy, neck and abdominal ultrasonography, chest and brain computerized tomography), administered dose, postablation I-131 whole body scan (WBS) and diagnostic I-131 WBS, neck USG, values of Tg and AntiTg at the 6th month were recorded. The presence of residual thyroid activity on the 6th month diagnostic I-131 WBS image was accepted as the criterion for ablation success.Results: 191 patients with differentiated thyroid cancer were assessed in this study. The overall success rate of the first ablation therapy was 74.3%. The success rate of the ablation therapy was 66% and 75% in metastatic group and non-metastatic group, respectively. Except the significant correlation between the number of pathologic lymph nodes and the success of ablation (p=0.025), there was no other significant correlation between the patient/disease related factors and the success of ablation therapy.Conclusion: Significant correlation between the number of the pathologic lymph nodes and the ablation therapy performance can also be due to statistical error because of the limited sample size. There was no significant correlation between other patient/disease related prognostic factors and the success of ablation therapy.Conflict of interest:None declared.
Highlights
Thyroid cancer is the one of rare type of cancers in humans that constitutes less than 1% of all cancers [1]
Therapy and Follow-up Standard dose was administered to all patients: 100 mCi to the patients with low-risk and without LNs or distant metastasis, 150-175 mCi to the patients with invasion to the thyroid capsule, lymph / blood vessels, surrounding soft tissue and without LNs or distant metastasis, 150-175 mCi to the patients with high risk and LNs metastasis at diagnosis, 200 mCi to the patients with high risk and distant metastases that was detected with imaging modalities. 50 mCi dose was given to 2 patients due to the large amount of residual tissue and 75 mCi dose was given to 3 patients secondary to the diagnosis of microcarcinoma
Significant relationship was not found between the ablation success and the categorical variables that belong to the patient and disease (Table 2)
Summary
Thyroid cancer is the one of rare type of cancers in humans that constitutes less than 1% of all cancers [1]. It has the highest mortality rate among the endocrine cancers [2]. Many prognostic scoring systems (TNM, AMES, AGES, MACIS, etc.) have been developed for the evaluation. The purpose of the scoring systems is to make the separation of low-and high-risk patients. Mortality and recurrence rate is very low in patients with low-risk. 10-year and 20-year mortality rate in the high risk group is 20-30% and 40% [3]. Prognostic factors include age, gender, type of surgical treatment, tumor size, tumor type, being multifocal / multicentric, thyroid capsule invasion, lymph/blood vessel invasion, lymph node (LNs) and distant metastases
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