Radioiodine versus no radioiodine outcomes in low-risk differentiated thyroid cancers: A propensity-score matched analysis

The 2015 American Thyroid Association guidelines recommend against radioiodine (RAI) ablation for patients with low-risk papillary microcarcinoma. However, its role in other low-risk differentiated thyroid cancer (DTC) patients remains controversial. Here, we compare long-term outcomes with RAI vers...

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Bibliographic Details
Published in:Clinical endocrinology (Oxford) 2023-11, Vol.99 (5), p.483-491
Main Authors: Satapathy, Swayamjeet, Tupalli, Avinash, Chandekar, Kunal Ramesh, Ballal, Sanjana, Bal, Chandrasekhar
Format: Article
Language:English
Subjects:
Ablation
Survival
Thyroglobulin
Thyroid cancer
Thyroid gland
Thyroidectomy
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Summary:The 2015 American Thyroid Association guidelines recommend against radioiodine (RAI) ablation for patients with low-risk papillary microcarcinoma. However, its role in other low-risk differentiated thyroid cancer (DTC) patients remains controversial. Here, we compare long-term outcomes with RAI versus no-RAI in a large cohort comprising all low-risk DTCs. Patients with low-risk, histologically-proven DTC post-thyroidectomy, treated with RAI or kept on follow-up without RAI, between 1990 and 2019 were included. The main outcomes included recurrence rate and recurrence-free survival (RFS), and were validated by propensity-score matching analysis. Of the 2074 low-risk DTC patients (median age: 35 years), 1686 patients underwent RAI-ablation (RAI group), while 388 patients underwent no-RAI follow-up (NOI group). Over a median follow-up of 8 years (range: 3-29), the recurrence rates were similar between the RAI and NOI groups (2.0% vs. 3.3%, p = .161). The 5- and 10-year RFS probabilities were 99.2% and 97.4%, respectively in RAI group versus 98.4% and 96.2%, respectively, in NOI group (p = .055). Subgroup regression analyses showed that patients with age 4 cm and elevated postoperative thyroglobulin.
ISSN:0300-0664
1365-2265
DOI:10.1111/cen.14950