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Horm Metab Res 2024; 56(11): 770-778
DOI: 10.1055/a-2423-4849
Original Article: Endocrine Care

The Prognostic Impact of Radioiodine Therapy in Patients with Papillary Thyroid Cancer

A Propensity Score Matched Case-Control Study
Matthias Schott
1   Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
,
Patricia Schott-Ohly
1   Division for Specific Endocrinology, Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
,
Sarah Krieg
2   Department of Inclusive Medicine, University Hospital Ostwestfalen-Lippe, Bielefeld University, Bielefeld, Germany
,
Cora Thomaschky
3   Department of General and Visceral Surgery, Thoracic Surgery and Proctology, University Hospital Herford, Medical Campus OWL, Ruhr University Bochum, Herford, Germany
,
Jan-Hendrik Wieltsch
3   Department of General and Visceral Surgery, Thoracic Surgery and Proctology, University Hospital Herford, Medical Campus OWL, Ruhr University Bochum, Herford, Germany
,
Alexander Petrovitch
4   Department of Diagnostic and Interventional Radiology and Neuroradiology, Klinikum Herford, Herford, Germany
,
Andreas Krieg
3   Department of General and Visceral Surgery, Thoracic Surgery and Proctology, University Hospital Herford, Medical Campus OWL, Ruhr University Bochum, Herford, Germany
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Abstract

Radioiodine (RAI) therapy after surgery, is an important component for the treatment of patients with papillary thyroid cancer (PTC), the most common thyroid cancer. In this study we sought to evaluate the cancer-specific survival (CSS) impact of RAI in specific thyroid cancer subgroups. The Surveillance, Epidemiology, and End Results (SEER) database were used to identify patients with PTC who underwent surgery between 2000 and 2019. Patients not treated with RAI were compared to those treated with RAI using propensity score matching (PSM) on the basis of identical inclusion criteria. A total of 106 333 patients were identified from the SEER database. RAI therapy was associated with improved CSS in the matched cohort (HR: 0.83; 95% CI: 0.72–0.96, p=0.01) but not in the unmatched data set (HR: 1.46; 95% CI: 1.30–1.64, p<0.001) among all PTC patients regardless of disease stage. Detailed analyses, however, showed that only patients with high-risk disease (pT3N1, pT4N1) experienced the greatest benefit in CSS. In the lower disease stages, no significant differences were recognized in the group of PTC patients with or without RAI therapy. One exception: in the group of PTC patients in stage pT1bN0, a significant difference was seen towards RAI. This is, however, most likely due to the large number of patients investigated. In summary, RAI therapy should not be used in low-risk PTC patients and might be used to some extent in intermediate-risk PTC patients. The histological suptype of the tumor needs to be considered in this context.

Keywords

papillary thyroid cancer - radioiodine therapy - cancer-specific mortality - SEER database


Publikationsverlauf

Eingereicht: 20. August 2024

Angenommen nach Revision: 22. September 2024

Artikel online veröffentlicht:
07. November 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14,70469 Stuttgart, Germany

 

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