High-dose radioactive iodine therapy is associated with decreased risk of recurrence in high-risk papillary thyroid cancer.

TitleHigh-dose radioactive iodine therapy is associated with decreased risk of recurrence in high-risk papillary thyroid cancer.
Publication TypeJournal Article
Year of Publication2019
AuthorsGray KD, Bannani S, Caillard C, Amanat S, Ullmann TM, Romanov P, Brunaud L, Beninato T, Fahey TJ, Mirallie E, Zarnegar R
JournalSurgery
Volume165
Issue1
Pagination37-43
Date Published2019 01
ISSN1532-7361
KeywordsCohort Studies, Female, Follow-Up Studies, France, Humans, Iodine Radioisotopes, Lymphatic Metastasis, Male, Matched-Pair Analysis, Middle Aged, Neck Dissection, Neoplasm Recurrence, Local, Radiotherapy Dosage, Retrospective Studies, Thyroid Cancer, Papillary, Thyroid Neoplasms, Thyroidectomy, United States
Abstract

OBJECTIVES: We aimed to determine the effect of adjuvant radioactive iodine dose on recurrence rate in high-risk papillary thyroid cancer.

METHODS: More than 1,500 patients treated for papillary thyroid cancer at high-volume centers in France and the United States from 2004-2014 were reviewed. Patients considered at high risk for recurrence per the 2015 American Thyroid Association guidelines were analyzed and grouped by initial radioactive iodine dose: intermediate (median 100 mCi) or high dose (median 150 mCi). Propensity score matching was performed to control for baseline characteristics.

RESULTS: In a propensity-matched cohort of 66 patient pairs, there were equivalent rates of gross extrathyroidal extension (71% vs 71%, P = 1.00), positive margins (55% vs 55%, P = 1.00), lymph node metastases ≥ 3 cm (9% vs 9%, P = 1.00), extranodal extension (32% vs 33%, P = .85), and distant metastases (2% vs 5%, P = .31). Over a median follow-up of 4.5 years (interquartile ratio 2.0-7.5 years), the intermediate-dose radioactive iodine group had a significantly higher rate of recurrence than patients in the high-dose radioactive iodine group: 24 out of 66 (36%) vs 13 out of 66 (20%), P = .03.

CONCLUSION: High-dose radioactive iodine is associated with lower recurrence rate compared with intermediate-dose radioactive iodine for patients with American Thyroid Association high-risk papillary thyroid cancer.

DOI10.1016/j.surg.2018.04.059
Alternate JournalSurgery
PubMed ID30274732