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Association of adjuvant radioactive iodine therapy with survival in node-positive papillary thyroid cancer.
Oral Oncol. 2018 12; 87:152-157.OO

Abstract

PURPOSE

To assess the effect of adding radioactive iodine (RAI) therapy to total thyroidectomy (TT) on overall survival (OS) in patients presenting with papillary thyroid cancer (PTC) and cervical pathologically proven LN metastases (pN1).

METHODS AND MATERIALS

We identified a cohort of patients with PTC and nodal metastases treated with TT alone or TT plus RAI in the Surveillance, Epidemiology and End Results database between 2004 and 2013. Propensity score 1-to-1 matching was used to balance baseline characteristics. Cox proportional hazards regression models and Kaplan-Meier survival analysis were used to test the relationship between RAI and OS.

RESULTS

In all, 15,953 patients were identified. After propensity score matching, 12,128 patients remained in each group. Based on multivariate Cox analysis, patients treated with TT + RAI had a statistically significant improvement in OS compared with those treated with TT alone [hazard ratio (HR) = 0.54, P < 0.001)], and significance persisted in the matched cohort (HR = 0.41, P < 0.001). In a subgroup analysis, the survival benefit was observed among patients ≥55 years but not among those <55 years (age < 55: HR = 1.06, P = 0.72; age ≥ 55: HR = 0.33, P < 0.001). Patients with stage T4 benefited most from RAI treatment (HR = 0.29, P < 0.001).

CONCLUSION

This propensity-matched analysis suggests that RAI therapy after TT was associated with improved OS in PTC patients with pN1 disease. Adjuvant RAI therapy needs to be considered in this patient group.

Authors+Show Affiliations

Department of Nuclear Medicine, the First Affiliated Hospital, Jinan University, 613 Huangpu West Road, Guangzhou 510630, China.Department of Nuclear Medicine, the First Affiliated Hospital, Jinan University, 613 Huangpu West Road, Guangzhou 510630, China.Department of Nuclear Medicine, the First Affiliated Hospital, Jinan University, 613 Huangpu West Road, Guangzhou 510630, China.Department of Nuclear Medicine, the First Affiliated Hospital, Jinan University, 613 Huangpu West Road, Guangzhou 510630, China.Department of Nuclear Medicine, the First Affiliated Hospital, Jinan University, 613 Huangpu West Road, Guangzhou 510630, China.Department of Nuclear Medicine, the First Affiliated Hospital, Jinan University, 613 Huangpu West Road, Guangzhou 510630, China. Electronic address: txh@jnu.edu.cn.

Pub Type(s)

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

Language

eng

PubMed ID

30527231

Citation

Sun, Yungang, et al. "Association of Adjuvant Radioactive Iodine Therapy With Survival in Node-positive Papillary Thyroid Cancer." Oral Oncology, vol. 87, 2018, pp. 152-157.
Sun Y, Gong J, Guo B, et al. Association of adjuvant radioactive iodine therapy with survival in node-positive papillary thyroid cancer. Oral Oncol. 2018;87:152-157.
Sun, Y., Gong, J., Guo, B., Shang, J., Cheng, Y., & Xu, H. (2018). Association of adjuvant radioactive iodine therapy with survival in node-positive papillary thyroid cancer. Oral Oncology, 87, 152-157. https://doi.org/10.1016/j.oraloncology.2018.10.041
Sun Y, et al. Association of Adjuvant Radioactive Iodine Therapy With Survival in Node-positive Papillary Thyroid Cancer. Oral Oncol. 2018;87:152-157. PubMed PMID: 30527231.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of adjuvant radioactive iodine therapy with survival in node-positive papillary thyroid cancer. AU - Sun,Yungang, AU - Gong,Jian, AU - Guo,Bin, AU - Shang,Jingjie, AU - Cheng,Yong, AU - Xu,Hao, Y1 - 2018/11/08/ PY - 2018/07/09/received PY - 2018/09/29/revised PY - 2018/10/31/accepted PY - 2018/12/12/entrez PY - 2018/12/12/pubmed PY - 2019/12/18/medline KW - Adjuvant therapy KW - Lymph node KW - Papillary thyroid cancer KW - Radioactive iodine KW - SEER KW - Survival SP - 152 EP - 157 JF - Oral oncology JO - Oral Oncol VL - 87 N2 - PURPOSE: To assess the effect of adding radioactive iodine (RAI) therapy to total thyroidectomy (TT) on overall survival (OS) in patients presenting with papillary thyroid cancer (PTC) and cervical pathologically proven LN metastases (pN1). METHODS AND MATERIALS: We identified a cohort of patients with PTC and nodal metastases treated with TT alone or TT plus RAI in the Surveillance, Epidemiology and End Results database between 2004 and 2013. Propensity score 1-to-1 matching was used to balance baseline characteristics. Cox proportional hazards regression models and Kaplan-Meier survival analysis were used to test the relationship between RAI and OS. RESULTS: In all, 15,953 patients were identified. After propensity score matching, 12,128 patients remained in each group. Based on multivariate Cox analysis, patients treated with TT + RAI had a statistically significant improvement in OS compared with those treated with TT alone [hazard ratio (HR) = 0.54, P < 0.001)], and significance persisted in the matched cohort (HR = 0.41, P < 0.001). In a subgroup analysis, the survival benefit was observed among patients ≥55 years but not among those <55 years (age < 55: HR = 1.06, P = 0.72; age ≥ 55: HR = 0.33, P < 0.001). Patients with stage T4 benefited most from RAI treatment (HR = 0.29, P < 0.001). CONCLUSION: This propensity-matched analysis suggests that RAI therapy after TT was associated with improved OS in PTC patients with pN1 disease. Adjuvant RAI therapy needs to be considered in this patient group. SN - 1879-0593 UR - https://www.unboundmedicine.com/medline/citation/30527231/Association_of_adjuvant_radioactive_iodine_therapy_with_survival_in_node_positive_papillary_thyroid_cancer_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1368-8375(18)30409-3 DB - PRIME DP - Unbound Medicine ER -