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Radioactive iodine ablation does not prevent recurrences in patients with papillary thyroid microcarcinoma.
Clin Endocrinol (Oxf). 2013 Apr; 78(4):614-20.CE

Abstract

OBJECTIVE

Although papillary thyroid microcarcinoma (PTMC) has a favourable long-term prognosis, disease recurrence after initial treatment remains a problem and controversy exists regarding the role of radioactive iodine (RAI) ablation in PTMC. We performed this study to evaluate the effect of RAI ablation on disease recurrence in patients with PTMC.

PATIENTS AND METHODS

Between 1994 and 2004, 2579 patients underwent thyroid surgery for thyroid cancer at Samsung Medical Center. Among these patients, 704 patients with PTMC presumed disease-free after initial treatment were followed up for disease recurrence (median, 64 months; range, 1-185 months). Patients with PTMC with microscopic extrathyroidal extension, cervical lymph node metastases or multifocality were considered to be in the intermediate-risk group for recurrence.

RESULTS

Disease recurrence was found in six patients at a median of 29 months (range, 10-70 months) after initial treatment; all six patients with recurrent tumours had received RAI treatment after total thyroidectomy. Disease-related mortality was not observed, even after recurrence. Based on a Cox regression model considering the standardized inverse probability of treatment weight (IPTW) within each propensity score stratum of patients with a similar likelihood of having received RAI ablation, the likelihood ratio for recurrence did not differ between the RAI ablation group and no RAI group (P = 0·17). When we performed a subgroup analysis considering only patients with PTMC at intermediate-risk for recurrence, RAI ablation again did not have a significant effect on recurrence (P = 0·79).

CONCLUSIONS

Radioactive iodine ablation after total thyroidectomy in low- and intermediate-risk patients with PTMC did not prevent recurrent tumours. Future randomized, controlled, multicenter prospective trials involving a larger sample of patients followed-up for a longer duration are warranted to confirm our findings.

Authors+Show Affiliations

Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22957654

Citation

Kim, Hye Jeong, et al. "Radioactive Iodine Ablation Does Not Prevent Recurrences in Patients With Papillary Thyroid Microcarcinoma." Clinical Endocrinology, vol. 78, no. 4, 2013, pp. 614-20.
Kim HJ, Kim NK, Choi JH, et al. Radioactive iodine ablation does not prevent recurrences in patients with papillary thyroid microcarcinoma. Clin Endocrinol (Oxf). 2013;78(4):614-20.
Kim, H. J., Kim, N. K., Choi, J. H., Kim, S. W., Jin, S. M., Suh, S., Bae, J. C., Min, Y. K., Chung, J. H., & Kim, S. W. (2013). Radioactive iodine ablation does not prevent recurrences in patients with papillary thyroid microcarcinoma. Clinical Endocrinology, 78(4), 614-20. https://doi.org/10.1111/cen.12034
Kim HJ, et al. Radioactive Iodine Ablation Does Not Prevent Recurrences in Patients With Papillary Thyroid Microcarcinoma. Clin Endocrinol (Oxf). 2013;78(4):614-20. PubMed PMID: 22957654.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radioactive iodine ablation does not prevent recurrences in patients with papillary thyroid microcarcinoma. AU - Kim,Hye Jeong, AU - Kim,Na Kyung, AU - Choi,Ji Hun, AU - Kim,Se Won, AU - Jin,Sang-Man, AU - Suh,Sunghwan, AU - Bae,Ji Cheol, AU - Min,Yong-Ki, AU - Chung,Jae Hoon, AU - Kim,Sun Wook, PY - 2012/07/09/received PY - 2012/08/04/revised PY - 2012/09/03/revised PY - 2012/09/03/accepted PY - 2012/9/11/entrez PY - 2012/9/11/pubmed PY - 2013/9/13/medline SP - 614 EP - 20 JF - Clinical endocrinology JO - Clin Endocrinol (Oxf) VL - 78 IS - 4 N2 - OBJECTIVE: Although papillary thyroid microcarcinoma (PTMC) has a favourable long-term prognosis, disease recurrence after initial treatment remains a problem and controversy exists regarding the role of radioactive iodine (RAI) ablation in PTMC. We performed this study to evaluate the effect of RAI ablation on disease recurrence in patients with PTMC. PATIENTS AND METHODS: Between 1994 and 2004, 2579 patients underwent thyroid surgery for thyroid cancer at Samsung Medical Center. Among these patients, 704 patients with PTMC presumed disease-free after initial treatment were followed up for disease recurrence (median, 64 months; range, 1-185 months). Patients with PTMC with microscopic extrathyroidal extension, cervical lymph node metastases or multifocality were considered to be in the intermediate-risk group for recurrence. RESULTS: Disease recurrence was found in six patients at a median of 29 months (range, 10-70 months) after initial treatment; all six patients with recurrent tumours had received RAI treatment after total thyroidectomy. Disease-related mortality was not observed, even after recurrence. Based on a Cox regression model considering the standardized inverse probability of treatment weight (IPTW) within each propensity score stratum of patients with a similar likelihood of having received RAI ablation, the likelihood ratio for recurrence did not differ between the RAI ablation group and no RAI group (P = 0·17). When we performed a subgroup analysis considering only patients with PTMC at intermediate-risk for recurrence, RAI ablation again did not have a significant effect on recurrence (P = 0·79). CONCLUSIONS: Radioactive iodine ablation after total thyroidectomy in low- and intermediate-risk patients with PTMC did not prevent recurrent tumours. Future randomized, controlled, multicenter prospective trials involving a larger sample of patients followed-up for a longer duration are warranted to confirm our findings. SN - 1365-2265 UR - https://www.unboundmedicine.com/medline/citation/22957654/Radioactive_iodine_ablation_does_not_prevent_recurrences_in_patients_with_papillary_thyroid_microcarcinoma_ L2 - https://doi.org/10.1111/cen.12034 DB - PRIME DP - Unbound Medicine ER -