Radioiodine (131I) treatment decision-making for low- and intermediate-risk differentiated thyroid cancer

Gao, Haiyan; Huang, Jhin‐Fang; Dai, Qingjing; Su, Juan

doi:10.20945/2359-3997000000538

Cited by 3 publications

(1 citation statement)

References 34 publications

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“…Previously, Gao et al. analyzed the data from low- and intermediate-risk patients with PTC and showed an ER rate of 93.7% and 78.2% after 131 I treatment ( 18 ), while Zhao et al. showed a 54.5%–73.2% ER achievement, which differed from high–low TSH level stratification ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological features affecting the efficacy in 131I ablation therapy of papillary thyroid carcinoma with lymph node metastasis

Xu,

Li,

et al. 2024

Front. Endocrinol.

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BackgroundLymph node metastasis is the major cause of increased recurrence and death in patients with papillary thyroid carcinoma (PTC). We evaluate the clinicopathologic factors affecting excellent response (ER) in patients with PTC with lymph node metastasis following operation and 131I ablation therapy.MethodsA total of 423 patients with PTC with lymph node metastasis who underwent thyroidectomy and postoperative 131I ablation therapy were enrolled. The relationship between clinicopathological factors affecting ER achievement was analyzed.ResultsMultivariate analysis showed that the foci diameter (≤1 cm), unifocal, combination with Hashimoto’s thyroiditis (HT), lymph node metastases rate (LR) (≤40%), no postoperative lymph node metastasis, low preablative stimulated thyroglobulin (ps-Tg) level (≤3.87 ng/mL), and the time of 131I ablation therapy (one time) were positively correlated with the ER achievement [odds ratio (OR): 1.744, 3.114, 3.920, 4.018, 2.074, 9.767, and 49.491, respectively; all p < 0.05]. The receiver operating characteristic (ROC) curves showed that the cutoff values of ps-Tg and LR were 4.625 ng/mL and 50.50%, respectively. The AUC of ROC of ps-Tg and LR for predicting ER achievement was 0.821 and 0.746, respectively. The Tg and the cumulative risk of non-ER elevated with the increase of LR, especially for the high-level ps-Tg (>4.625 ng/mL) group.ConclusionThe foci diameter and number, combination with HT, LR, and ps-Tg level are independent factors for ER. Ps-Tg level and LR are valid predictive factors for the efficacy of 131I therapy in patients with PTC. The predictive value of the cumulative risk of non-ER can be improved by the combination of ps-Tg and LR.

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Section: Discussionmentioning

confidence: 99%

Clinicopathological features affecting the efficacy in 131I ablation therapy of papillary thyroid carcinoma with lymph node metastasis

Xu,

Li,

et al. 2024

Front. Endocrinol.

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Postoperative thyroglobulin as a yard-stick for radioiodine therapy: decision tree analysis in a European multicenter series of 1317 patients with differentiated thyroid cancer

Giovanella

Milan

Roll

et al. 2023

Eur J Nucl Med Mol Imaging

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Purpose An accurate postoperative assessment is pivotal to inform postoperative 131I treatment in patients with differentiated thyroid cancer (DTC). We developed a predictive model for post-treatment whole-body scintigraphy (PT-WBS) results (as a proxy for persistent disease) by adopting a decision tree model. Methods Age, sex, histology, T stage, N stage, risk classes, remnant estimation, TSH, and Tg were identified as potential predictors and were put into regression algorithm (conditional inference tree, ctree) to develop a risk stratification model for predicting the presence of metastases in PT-WBS. Results The lymph node (N) stage identified a partition of the population into two subgroups (N-positive vs N-negative). Among N-positive patients, a Tg value > 23.3 ng/mL conferred a 83% probability to have metastatic disease compared to those with lower Tg values. Additionally, N-negative patients were further substratified in three subgroups with different risk rates according to their Tg values. The model remained stable and reproducible in the iterative process of cross validation. Conclusions We developed a simple and robust decision tree model able to provide reliable informations on the probability of persistent/metastatic DTC after surgery. These information may guide post-surgery 131I administration and select patients requiring curative rather than adjuvant 131I therapy schedules.

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Current practice in intermediate risk differentiated thyroid cancer – a review

do Prado Padovani,

Duarte,

Nascimento

2023

Rev Endocr Metab Disord

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Radioiodine (131I) treatment decision-making for low- and intermediate-risk differentiated thyroid cancer

Cited by 3 publications

References 34 publications

Clinicopathological features affecting the efficacy in 131I ablation therapy of papillary thyroid carcinoma with lymph node metastasis

Clinicopathological features affecting the efficacy in 131I ablation therapy of papillary thyroid carcinoma with lymph node metastasis

Postoperative thyroglobulin as a yard-stick for radioiodine therapy: decision tree analysis in a European multicenter series of 1317 patients with differentiated thyroid cancer

Current practice in intermediate risk differentiated thyroid cancer – a review

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