Efficacy of postoperative radioactive iodine therapy for patients with low and intermediate risk papillary thyroid carcinoma.

IF 3.7 3区医学 Q2 Medicine

Endocrine Pub Date : 2024-09-23 DOI:10.1007/s12020-024-04046-1

Hyeon A Lee, Chang Myeon Song, Yong Bae Ji, Ji Young Kim, Soo Jin Lee, Yun Young Choi, Kyung Tae

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Abstract

Purpose: This study aimed to evaluate the efficacy of postoperative radioactive iodine (RAI) and its impact on recurrence rates and survival benefits in low- to intermediate-risk papillary thyroid carcinoma (PTC).

Methods: This retrospective study involved the examination of 1286 patients diagnosed with low- to intermediate-risk PTC who underwent total thyroidectomy with or without neck dissection, supplemented with postoperative RAI therapy or not between the years 2000 and 2021.

Results: From the patient pool, 589 (45%) were classified as low-risk and 697 (55%) as intermediate-risk according to the 2015 American Thyroid Association guidelines. Among the low-risk group, 375 (63.7%) underwent postoperative RAI, while in the intermediate-risk group, 566 (82.2%) underwent the procedure. The overall survival and disease-free survival rates were not statistically different between the groups that received RAI and those that did not, in both the low- and intermediate-risk categories. In a subgroup analysis, within the intermediate-risk category, postoperative RAI was significantly correlated with decreased recurrence in two subgroups: patients over 55 years with pN1b disease (hazard ratio 0.043, 95% confidence interval 0.004-0.500, p = 0.012) and patients over 55 years with five or more metastatic lymph nodes (hazard ratio 0.060, 95% confidence interval 0.005-0.675, p = 0.023).

Conclusion: Our findings suggest that, while post-total thyroidectomy RAI does not substantially influence recurrence or survival rates in most low-risk and intermediate-risk PTC patients, it may be beneficial in specific subgroups, particularly patients over 55 with pN1b disease or those presenting with five or more metastatic lymph nodes.

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对中低危甲状腺乳头状癌患者进行术后放射性碘治疗的疗效。

目的：本研究旨在评估术后放射性碘（RAI）的疗效及其对中低风险甲状腺乳头状癌（PTC）复发率和生存率的影响：这项回顾性研究对2000年至2021年期间被诊断为中低风险PTC的1286名患者进行了检查，这些患者接受了全甲状腺切除术，同时进行或不进行颈部切除术，术后是否辅以RAI治疗：根据2015年美国甲状腺协会指南，患者中有589人（45%）被列为低危患者，697人（55%）被列为中危患者。在低风险组中，375人（63.7%）接受了术后RAI治疗，而在中风险组中，566人（82.2%）接受了该治疗。在低风险组和中风险组中，接受 RAI 治疗组和未接受 RAI 治疗组的总生存率和无病生存率没有统计学差异。在亚组分析中，在中危类别中，术后 RAI 与两个亚组的复发率显著相关：55 岁以上患有 pN1b 疾病的患者（危险比为 0.043，95% 置信区间为 0.004-0.500，p = 0.012）和 55 岁以上患有 5 个或更多转移淋巴结的患者（危险比为 0.060，95% 置信区间为 0.005-0.675，p = 0.023）：我们的研究结果表明，虽然甲状腺全切除术后 RAI 不会对大多数低风险和中风险 PTC 患者的复发率或生存率产生重大影响，但它可能对特定亚群有益，尤其是 55 岁以上患有 pN1b 病变或有五个或五个以上转移淋巴结的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.