Impact on Overall Survival of Radioactive Iodine in Low-Risk Differentiated Thyroid Cancer Patients

Schvartz, Claire; Bonnetain, Franck; Dabakuyo, S.; Gauthier, Mélanie; Cueff, A.; Fieffe, S.; Pochart, Jean-Marie; Cochet, I.; Crevisy, E.; Dalac, A.; Papathanassiou, Dimitri; Toubeau, Michel

doi:10.1210/jc.2011-2512

Cited by 188 publications

(107 citation statements)

References 27 publications

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“…The mean dose of RAI used was 90mCi. 26 Another retrospective study assessing low-risk PTC patients, of whom only 55% had macrocarcinoma and who were not treated with RAI, found a structural recurrence rate of 2.3%. 27 The current ATA guidelines report that "RAI remnant ablation is not routinely recommended after thyroidectomy for ATA low-risk DTC patients.…”

Section: Discussionmentioning

confidence: 99%

“…1,16,25 The overall mortality in low-risk DTC patients for a median follow-up of 10 years is approximately 5%, either with or without RAI ablation. 26 Furthermore, several studies and meta-analyses have demonstrated that postoperative RAI administration in low-risk DTC patients fails to improve the overall survival rate.…”

Section: Discussionmentioning

confidence: 99%

“…1, 16,26 The role of postoperative RAI administration in recurrence in low-risk DTC patients is less clear due to the lack of randomized, controlled studies. one recently published retrospective controlled study with 1,298 low-risk macrocarcinoma DTC patients failed to demonstrate any benefit as regards the structural recurrence rate or overall survival during a median follow-up duration of 10.3 years.…”

Section: Discussionmentioning

confidence: 99%

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Low-risk papillary thyroid carcinoma patients who underwent near-total thyroidectomy without prophylactic central compartment lymph node dissection and were ablated with low-dose 50mCi RAI had excellent 10-year prognosis

Michalaki

Bountouris

Roupas

et al. 2016

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BAcKgrounD: The current trend in the management of low risk differentiated thyroid carcinoma is to follow less aggressive strategies. oBjEcTIVE: To assess the long-term morbidity and mortality outcomes of low-risk papillary thyroid carcinoma (pTc) patients undergoing minimal intervention. DEsIgn: we retrospectively analyzed 137 patients with low-risk pTc (stage I: n=77; stage II: n=60). of these patients, 107 (group 1) had macro-pTc and underwent near-total thyroidectomy and received postoperatively 50mci rAI. The remaining 30 patients (group 2) had micro-pTc (<1cm) and were treated only by means of near-total thyroidectomy. rEsulTs: The median follow-up for group 1 patients was 10 years (range: 3-30). At 1-year evaluation, 8 patients of group 1 had indeterminate or incomplete biochemical response, of whom 4 had also incomplete structural response to initial therapy. only 1 of 4 patients with structural incomplete response underwent cervical lymph node dissection and then received an additional dose of 100mci rAI. The remaining 7 patients received only an additional dose of 100mci rAI. These patients have been continuously followed till the present time with no recurrences or deaths (median follow-up: 17.5 years; 3-30 years). At 15 years, 2 patients of group 1 experienced biochemical recurrence and they received 100mci rAI. Three patients of group 2 experienced recurrence, with 2 receiving 50mci rAI and 1 undergoing cervical lymph node dissection with 50mci rAI. conclusIons: patients with low-risk macro-pTc treated by means of near-total thyroidectomy without pcclnD and receiving postoperatively a low dose of 50mci rAI have excellent long-term prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Low-risk papillary thyroid carcinoma patients who underwent near-total thyroidectomy without prophylactic central compartment lymph node dissection and were ablated with low-dose 50mCi RAI had excellent 10-year prognosis

Michalaki

Bountouris

Roupas

et al. 2016

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“…Un estudio retrospectivo multicéntrico, donde se evaluaron 1,298 pacientes de bajo riesgo, con un seguimiento promedio de 10.3 años, no encontró beneficios de la ablación con yodo 131 en relación con la supervivencia global y la supervivencia libre de progresión 35 . En concreto, existe poca evidencia que apoye el uso de yodo 131 en estos pacientes.…”

Section: Pacientes De Riesgo Bajounclassified

La medicina nuclear y el cáncer diferenciado de tiroides

Medina-Ornelas¹,

García-Pérez²,

Granados-García³

2022

GAMO

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Gaceta Mexicana de Oncologia. 2017;16(4):239-248 resumen: Los afectados por cáncer diferenciado de tiroides (CDT) suelen tener un curso clí-nico favorable, pero algunos pueden mostrar un curso agresivo con recaídas. El tratamiento óptimo aún es controvertido, en especial respecto a la extensión de la cirugía, las indicaciones de radioyodo y la supresión de hormona estimuladora del tiroides (TSH). La evaluación correcta de los riesgos facilita un enfoque selectivo de la terapia. Presentamos una revisión del papel de la medicina nuclear en la evaluación, tratamiento y seguimiento de pacientes afectados por esta interesante enfermedad. (creativecommons.org/licenses/by-nc-nd/4.0/). abstract Those affected by differentiated thyroid cancer tend to have a favorable clinical course, but some may show an aggressive course with relapses. The optimal treatment is still controversial, especially regarding the extent of surgery, indications for radioiodine and suppression of thyroid-stimulating hormone. Correct risk assessment facilitates a selective approach to therapy. We present a review of the role of nuclear medicine in the evaluation, treatment and follow-up of patients affected by this interesting disease. PalaBraS ClaVECáncer de tiroides; Radioyodo; Medicina nuclear; Tratamiento KEY WorDSThyroid cancer; Radioiodine; Nuclear medicine; Treatment introDuCCión Según Globocan, en 2012 en México ocurrieron 3,036 casos de cáncer de tiroides (725 en hombres y 2,311 en mujeres), que constituyeron el 2.1% del total de neoplasias malignas 1 . El CDT representa al menos el 85% de los casos e incluye los tipos papilar, folicular y de células de Hürtle. El cáncer papilar, el tipo más frecuente, se asocia a una excelente supervivencia, pero algunos pacientes tienen un curso clínico menos favorable, con metástasis o recaídas que afectan a los ganglios linfáticos cervicales y, con menor frecuencia, a los pulmones y el hueso 2,3 . La medicina nuclear se sirve de las peculiaridades de la fisiopatología del CDT y juega un papel muy importante tanto en el tratamiento adyuvante como en el seguimiento y manejo de las recaídas. El tratamiento debe ser el más eficaz posible, con las menores secuelas y el menor costo; por ello se enfatiza el tratamiento individualizado, acorde al tipo histológico, la extensión de la enfermedad y el riesgo de recaída. YoDo 131El yodo 131 ([131]I o radioyodo) es producido en un reactor nuclear mediante la irradiación neutrónica de dióxido de telurio durante la fisión del uranio. Su vida media física es de 8.02 días. Los átomos del yodo 131 emiten partículas β con

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“…However, National Thyroid Cancer Treatment Cooperative Study Group (NTCTCSG) published data of 4,767 patients with >5 year follow-up in 2010 with a revised conclusion of no significant impact of RAI ablation upon survival of low risk patients (Jonklaas et al, 2010). NTCTCSG also ruled out its previous findings published in 2006 showing adverse effect of RAI on over-all survival in low risk patient (Schvartz et al, 2012 failed to prove any survival benefit of RAI after surgery in low risk group with WDTC. So the controversy is still on about the use of RAI in low risk patients with WDTC as available data are fueled by retrospective and non-randomized clinical studies.…”

Section: Remnant Ablation or Not In Low Risk Wdtc?mentioning

confidence: 99%

Controversies about Radioactive Iodine-131 Remnant Ablation in Low Risk Thyroid Cancers: Are We Near A Consensus?

Zaman¹,

Fatima²,

Padhy³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Well differentiated thyroid cancers (WDTC), including papillary (80%) and follicular (10%) types, are the most common endocrine cancers globally. Over the last few decades most the diagnosed cases have fallen into low risk categories. Radioactive iodine-131 (RAI) has an established role in reducing recurrence and improving the survival in high risk patients. In patients with primary tumor size <1 cm, RAI is not recommended by many thyroid societies. However, low risk WDTC has been an arena of major controversies, most importantly the role and dose of adjuvant RAI for remnant ablation to minimize chances of recurrence and improving survival. This review is an attempt to update readers about the previous and existing practice based on results of nonrandomized trials and evolving trends fueled by recently published randomized studies.

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Impact on Overall Survival of Radioactive Iodine in Low-Risk Differentiated Thyroid Cancer Patients

Abstract: With a long-term follow-up of 10.3 yr, we failed to prove any survival benefit of RAI after surgery in a large cohort of low-risk DTC patients.

Cited by 188 publications

References 27 publications

Low-risk papillary thyroid carcinoma patients who underwent near-total thyroidectomy without prophylactic central compartment lymph node dissection and were ablated with low-dose 50mCi RAI had excellent 10-year prognosis

Low-risk papillary thyroid carcinoma patients who underwent near-total thyroidectomy without prophylactic central compartment lymph node dissection and were ablated with low-dose 50mCi RAI had excellent 10-year prognosis

La medicina nuclear y el cáncer diferenciado de tiroides

Controversies about Radioactive Iodine-131 Remnant Ablation in Low Risk Thyroid Cancers: Are We Near A Consensus?

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