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Effects of low-dose and high-dose postoperative radioiodine therapy on the clinical outcome in patients with small differentiated thyroid cancer having microscopic extrathyroidal extension.
Thyroid. 2014 May; 24(5):820-5.T

Abstract

BACKGROUND

It is unclear whether differentiated thyroid cancer (DTC) patients classified as intermediate risk based on the presence of microscopic extrathyroidal extension (ETE) should be treated with low or high doses of radioiodine (RAI) after surgery. We evaluated success rates and long-term clinical outcomes of patients with DTC of small tumor size, microscopic ETE, and no cervical lymph node (LN) metastasis treated either with a low (1.1 GBq) or high RAI dose (5.5 GBq).

METHODS

This is a retrospective analysis of a historical cohort from 2000 to 2010 in a tertiary referral hospital. A total of 176 patients with small (≤2 cm) DTC, microscopic ETE, and no cervical LN metastasis were included. Ninety-six patients were treated with 1.1 GBq (LO group) and 80 patients with 5.5 GBq (HI group). Successful RAI therapy was defined as (i) negative stimulated thyroglobulin (Tg) in the absence of Tg antibodies, and (ii) absence of remnant thyroid tissue and of abnormal cervical LNs on ultrasonography. Clinical recurrence was defined as the reappearance of disease after ablation, which was confirmed by cytologically or pathologically proven malignant tissue or of distant metastatic lesions.

RESULTS

There was no significant difference in the rate of successful RAI therapy between the LO and HI groups (p=0.75). In a subgroup analysis based on tumor size, success rates were not different between the LO group (34/35, 97%) and the HI group (50/56, 89%) in patients with a tumor size of 1-2 cm (p=0.24). In patients with smaller tumor size (≤1 cm), there was no significant difference in success rates between the LO (59/61, 97%) and HI groups (22/24, 92%; p=0.30). No patient had clinical recurrences in either group during the median 7.2 years of follow-up.

CONCLUSIONS

Low-dose RAI therapy is sufficient to treat DTC patients classified as intermediate risk just by the presence of microscopic ETE.

Authors+Show Affiliations

1 Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine , Seoul, South 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 available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24328997

Citation

Han, Ji Min, et al. "Effects of Low-dose and High-dose Postoperative Radioiodine Therapy On the Clinical Outcome in Patients With Small Differentiated Thyroid Cancer Having Microscopic Extrathyroidal Extension." Thyroid : Official Journal of the American Thyroid Association, vol. 24, no. 5, 2014, pp. 820-5.
Han JM, Kim WG, Kim TY, et al. Effects of low-dose and high-dose postoperative radioiodine therapy on the clinical outcome in patients with small differentiated thyroid cancer having microscopic extrathyroidal extension. Thyroid. 2014;24(5):820-5.
Han, J. M., Kim, W. G., Kim, T. Y., Jeon, M. J., Ryu, J. S., Song, D. E., Hong, S. J., Shong, Y. K., & Kim, W. B. (2014). Effects of low-dose and high-dose postoperative radioiodine therapy on the clinical outcome in patients with small differentiated thyroid cancer having microscopic extrathyroidal extension. Thyroid : Official Journal of the American Thyroid Association, 24(5), 820-5. https://doi.org/10.1089/thy.2013.0362
Han JM, et al. Effects of Low-dose and High-dose Postoperative Radioiodine Therapy On the Clinical Outcome in Patients With Small Differentiated Thyroid Cancer Having Microscopic Extrathyroidal Extension. Thyroid. 2014;24(5):820-5. PubMed PMID: 24328997.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of low-dose and high-dose postoperative radioiodine therapy on the clinical outcome in patients with small differentiated thyroid cancer having microscopic extrathyroidal extension. AU - Han,Ji Min, AU - Kim,Won Gu, AU - Kim,Tae Yong, AU - Jeon,Min Ji, AU - Ryu,Jin-Sook, AU - Song,Dong Eun, AU - Hong,Suck Joon, AU - Shong,Young Kee, AU - Kim,Won Bae, Y1 - 2014/01/29/ PY - 2013/12/17/entrez PY - 2013/12/18/pubmed PY - 2015/1/13/medline SP - 820 EP - 5 JF - Thyroid : official journal of the American Thyroid Association JO - Thyroid VL - 24 IS - 5 N2 - BACKGROUND: It is unclear whether differentiated thyroid cancer (DTC) patients classified as intermediate risk based on the presence of microscopic extrathyroidal extension (ETE) should be treated with low or high doses of radioiodine (RAI) after surgery. We evaluated success rates and long-term clinical outcomes of patients with DTC of small tumor size, microscopic ETE, and no cervical lymph node (LN) metastasis treated either with a low (1.1 GBq) or high RAI dose (5.5 GBq). METHODS: This is a retrospective analysis of a historical cohort from 2000 to 2010 in a tertiary referral hospital. A total of 176 patients with small (≤2 cm) DTC, microscopic ETE, and no cervical LN metastasis were included. Ninety-six patients were treated with 1.1 GBq (LO group) and 80 patients with 5.5 GBq (HI group). Successful RAI therapy was defined as (i) negative stimulated thyroglobulin (Tg) in the absence of Tg antibodies, and (ii) absence of remnant thyroid tissue and of abnormal cervical LNs on ultrasonography. Clinical recurrence was defined as the reappearance of disease after ablation, which was confirmed by cytologically or pathologically proven malignant tissue or of distant metastatic lesions. RESULTS: There was no significant difference in the rate of successful RAI therapy between the LO and HI groups (p=0.75). In a subgroup analysis based on tumor size, success rates were not different between the LO group (34/35, 97%) and the HI group (50/56, 89%) in patients with a tumor size of 1-2 cm (p=0.24). In patients with smaller tumor size (≤1 cm), there was no significant difference in success rates between the LO (59/61, 97%) and HI groups (22/24, 92%; p=0.30). No patient had clinical recurrences in either group during the median 7.2 years of follow-up. CONCLUSIONS: Low-dose RAI therapy is sufficient to treat DTC patients classified as intermediate risk just by the presence of microscopic ETE. SN - 1557-9077 UR - https://www.unboundmedicine.com/medline/citation/24328997/Effects_of_low_dose_and_high_dose_postoperative_radioiodine_therapy_on_the_clinical_outcome_in_patients_with_small_differentiated_thyroid_cancer_having_microscopic_extrathyroidal_extension_ L2 - https://www.liebertpub.com/doi/10.1089/thy.2013.0362?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -