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Timing of Radioactive Iodine Administration Does Not Influence Outcomes in Patients with Differentiated Thyroid Carcinoma.
Thyroid. 2016 11; 26(11):1623-1629.T

Abstract

BACKGROUND

Radioactive iodine (RAI) is widely used in the management of differentiated thyroid cancer (DTC). The impact of the time interval between total thyroidectomy (TT) and RAI administration on disease outcome remains controversial. The objective of the present study was to evaluate the impact of the time interval between TT and RAI.

METHODS

This study evaluated a cohort of DTC patients who received RAI therapy for whom data on disease status were available. Patients were allocated to one of two groups, according to the time interval between TT and RAI. "Disease-free" was defined as no clinical, imaging, or biochemical evidence of thyroid cancer.

RESULTS

The study included 545 individuals. The TNM stages were: 322 (59.1%) patients in Stage I, 62 (11.4%) in Stage II, 65 (11.9%) in Stage III, and 82 (15.0%) in Stage IV. The median time interval between TT and RAI was six months (P25-75: 3-10 months). Patients were allocated to one of two groups according to RAI timing administration: group A ≤6 months after TT (median 3 months; n = 295), or group B >6 months after TT (median 10.5 months; n = 250). There were no differences for sex, histological type, tumor size, distant metastasis, or RAI dose between the groups (p > 0.1). Patients in group B were older (47.1 vs. 43.1 years; p = 0.02), had less cervical metastasis (73.6% vs. 59.3%; p = 0.002), and were more commonly classified as low ATA risk (48.0% vs. 36.6%; p = 0.027). One year after initial therapy, 59.3% and 65.6% of patients in groups A and B, respectively, were considered disease-free (p = 0.15). Remarkably, the percentage of patients classified as disease-free was similar, even when analyzing a subgroup of high-risk patients (n = 72; 9.5% vs. 10.0%; p = 1.0). These findings did not change after a median of six years of follow-up. Accordingly, further analysis by multiple logistic regression showed that timing of RAI was not associated with persistent disease (relative risk 0.97 [confidence interval 0.80-1.19]).

CONCLUSIONS

Timing of RAI does not seem to interfere with the disease outcomes in DTC and can therefore be safely planned while taking into account the health system logistics.

Authors+Show Affiliations

Thyroid Section, Endocrine Division, Hospital de Clínicas de Porto Alegre, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul , Porto Alegre, Brazil .Thyroid Section, Endocrine Division, Hospital de Clínicas de Porto Alegre, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul , Porto Alegre, Brazil .Thyroid Section, Endocrine Division, Hospital de Clínicas de Porto Alegre, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul , Porto Alegre, Brazil .Thyroid Section, Endocrine Division, Hospital de Clínicas de Porto Alegre, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul , Porto Alegre, Brazil .

Pub Type(s)

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

Language

eng

PubMed ID

27549175

Citation

Scheffel, Rafael Selbach, et al. "Timing of Radioactive Iodine Administration Does Not Influence Outcomes in Patients With Differentiated Thyroid Carcinoma." Thyroid : Official Journal of the American Thyroid Association, vol. 26, no. 11, 2016, pp. 1623-1629.
Scheffel RS, Zanella AB, Dora JM, et al. Timing of Radioactive Iodine Administration Does Not Influence Outcomes in Patients with Differentiated Thyroid Carcinoma. Thyroid. 2016;26(11):1623-1629.
Scheffel, R. S., Zanella, A. B., Dora, J. M., & Maia, A. L. (2016). Timing of Radioactive Iodine Administration Does Not Influence Outcomes in Patients with Differentiated Thyroid Carcinoma. Thyroid : Official Journal of the American Thyroid Association, 26(11), 1623-1629.
Scheffel RS, et al. Timing of Radioactive Iodine Administration Does Not Influence Outcomes in Patients With Differentiated Thyroid Carcinoma. Thyroid. 2016;26(11):1623-1629. PubMed PMID: 27549175.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Timing of Radioactive Iodine Administration Does Not Influence Outcomes in Patients with Differentiated Thyroid Carcinoma. AU - Scheffel,Rafael Selbach, AU - Zanella,André B, AU - Dora,José Miguel, AU - Maia,Ana Luiza, Y1 - 2016/09/22/ PY - 2016/11/2/pubmed PY - 2018/2/10/medline PY - 2016/8/24/entrez KW - differentiated thyroid carcinoma KW - outcome KW - radioactive iodine therapy KW - timing of radioactive iodine administration SP - 1623 EP - 1629 JF - Thyroid : official journal of the American Thyroid Association JO - Thyroid VL - 26 IS - 11 N2 - BACKGROUND: Radioactive iodine (RAI) is widely used in the management of differentiated thyroid cancer (DTC). The impact of the time interval between total thyroidectomy (TT) and RAI administration on disease outcome remains controversial. The objective of the present study was to evaluate the impact of the time interval between TT and RAI. METHODS: This study evaluated a cohort of DTC patients who received RAI therapy for whom data on disease status were available. Patients were allocated to one of two groups, according to the time interval between TT and RAI. "Disease-free" was defined as no clinical, imaging, or biochemical evidence of thyroid cancer. RESULTS: The study included 545 individuals. The TNM stages were: 322 (59.1%) patients in Stage I, 62 (11.4%) in Stage II, 65 (11.9%) in Stage III, and 82 (15.0%) in Stage IV. The median time interval between TT and RAI was six months (P25-75: 3-10 months). Patients were allocated to one of two groups according to RAI timing administration: group A ≤6 months after TT (median 3 months; n = 295), or group B >6 months after TT (median 10.5 months; n = 250). There were no differences for sex, histological type, tumor size, distant metastasis, or RAI dose between the groups (p > 0.1). Patients in group B were older (47.1 vs. 43.1 years; p = 0.02), had less cervical metastasis (73.6% vs. 59.3%; p = 0.002), and were more commonly classified as low ATA risk (48.0% vs. 36.6%; p = 0.027). One year after initial therapy, 59.3% and 65.6% of patients in groups A and B, respectively, were considered disease-free (p = 0.15). Remarkably, the percentage of patients classified as disease-free was similar, even when analyzing a subgroup of high-risk patients (n = 72; 9.5% vs. 10.0%; p = 1.0). These findings did not change after a median of six years of follow-up. Accordingly, further analysis by multiple logistic regression showed that timing of RAI was not associated with persistent disease (relative risk 0.97 [confidence interval 0.80-1.19]). CONCLUSIONS: Timing of RAI does not seem to interfere with the disease outcomes in DTC and can therefore be safely planned while taking into account the health system logistics. SN - 1557-9077 UR - https://www.unboundmedicine.com/medline/citation/27549175/Timing_of_Radioactive_Iodine_Administration_Does_Not_Influence_Outcomes_in_Patients_with_Differentiated_Thyroid_Carcinoma_ L2 - https://www.liebertpub.com/doi/10.1089/thy.2016.0038?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -