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KMID : 1148920190530050320
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Nuclear Medicine and Molecular Imaging
2019 Volume.53 No. 5 p.320 ~ p.327
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Postoperative Radioiodine Treatment within 9 Months from Diagnosis Significantly Reduces the Risk of Relapse in Low-Risk Differentiated Thyroid Carcinoma
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Krajewska Jolanta
Jarzab Michal
Kukulska Aleksandra
Czarniecka Agnieszka
Roskosz Jozef
Puch Zbigniew
Wygoda Zbigniew
Paliczka-Cieslik Ewa
Kropinska Aleksandra
Krol Aleksandra
Handkiewicz-Junak Daria
Jarzab Barbara
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Abstract
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Purpose: Although postoperative radioiodine (RAI) therapy has been used in patients with differentiated thyroid carcinoma (DTC) for many years, there is still lack of data defining the timing of RAI administration. A retrospective analysis was carried out to answer the question whether the time of postoperative RAI treatment demonstrated any impact on long-term outcomes, particularly in low-risk DTC.
Material: The analyzed group involved 701 DTC patients staged pT1b-T4N0-N1M0, who underwent total thyroidectomy and postoperative RAI therapy. According to the time interval between DTC diagnosis and RAI administration, patients were allocated to one of three groups: up to 9 months (N?=?150), between 9 and 24 months (N?=?323), and >?24 months (N?=?228). Median follow-up was 12.1 years (1.5?15.2).
Results: Based on an initial DTC advancement and postoperative stimulated thyroglobulin concentration patients were stratified as a low-, intermediate-, and high-risk group. Low-risk patients, who received RAI therapy up to 9 months, demonstrated significantly lower risk of relapse comparing to those, in whom RAI was administered between 9 and 24 months and after 24 months since DTC diagnosis: 0%, 5.5%, and 7.1%, respectively. Regarding intermediate- and high-risk groups, the differences in the timing of postoperative RAI treatment were not significant.
Conclusion: If postoperative RAI treatment is considered in low-risk DTC, any delay in RAI administration above 9 months since diagnosis may be related to poorer long-term outcomes.
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KEYWORD
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Differentiated thyroid cancer, Radioiodine treatment, Low-risk differentiated thyroid cancer, Recurrence, Relapse
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