Katherine D Gray1, Sahar Bannani2, Cécile Caillard2, Sonia Amanat1, Timothy M Ullmann1, Pavel Romanov1, Laurent Brunaud3, Toni Beninato1, Thomas J Fahey1, Eric Mirallie2, Rasa Zarnegar4. 1. New York Presbyterian Hospital-Weill Cornell Medicine Department of Surgery, New York, NY. 2. Clinique de Chirurgie Digestive et Endocrinienne, Nantes, France. 3. Service Chirurgie Digestive, Hépato-bilaire, Endocrinienne et Cancérologique Unité Multidisciplinaire de la Chirurgie de L'obésité (UMCO), Université de Lorraine, CHU Nancy Hopital Brabois, Vandoeuvre-les-Nancy, France. 4. New York Presbyterian Hospital-Weill Cornell Medicine Department of Surgery, New York, NY. Electronic address: raz2002@med.cornell.edu.
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.
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.
Authors: Ayanthi Wijewardene; Matti Gild; Carolina Nylén; Geoffrey Schembri; Paul Roach; Jeremy Hoang; Ahmad Aniss; Anthony Glover; Mark Sywak; Stan Sidhu; Diana Learoyd; Bruce Robinson; Lyndal Tacon; Roderick Clifton-Bligh Journal: Eur Thyroid J Date: 2021-05-25