Researchers published the study covered in this summary on Research Square as a preprint that has not yet been peer reviewed.
Key Takeaways
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Low-risk patients with differentiated thyroid cancer (DTC) showed similarly good outcomes regardless of whether they received adjuvant radioiodine ablation (RA) following total thyroidectomy in a prospective, multicenter study, suggesting that this treatment should not routinely be used for these patients.
Why This Matters
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Routine use of adjuvant RA in patients with low- to intermediate-risk DTC is not endorsed by the current American Thyroid Association (ATA) guidelines, but it is routinely recommended by nuclear medicine specialists in European countries for selected patients with low-risk tumors and for most intermediate-risk cases. It is also widely used in Argentina.
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Benefits of not performing RA include avoiding radiation exposure and its potential adverse effects, lower cost, and less disruption to a patient's life.
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Previously published meta-analyses did not report an advantage of RA in low-risk patients in terms of survival and recurrence.
Study Design
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This was a prospective, nonrandomized study of 174 consecutive patients with low-risk DTC who underwent total thyroidectomy at any of 14 centers in Buenos Aires from June 2014 to May 2015, including 87 patients who received adjuvant RA and 87 who did not.
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Patients at low risk for recurrent DTC were identified using criteria endorsed in the ATA's 2015 guidelines.
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Treatment response was evaluated based on thyroglobulin levels, antithyroglobulin antibodies levels, and neck ultrasonography at 6-18 months after thyroidectomy and at the end of follow-up.
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Researchers performed a 6-18 month evaluation on 161 patients and long-term follow-up of at least 24 months on 139 patients, with a median follow-up of about 60 months.
Key Results
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An excellent response to initial treatment occurred in 77.7% of patients treated with RA and in 87.7% not treated with RA, a nonsignificant difference.
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Among the 58 ablated patients with long-term follow-up, 82.8% had no evidence of disease, and among the 81 nonablated patients followed long-term, 90.0% had no evidence of disease, a nonsignificant difference.
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No patient had evidence of structural disease at the end of follow-up.
Limitations
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This was a nonrandomized study, and hence, had the potential for selection bias.
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The number of enrolled patients varied among the 14 participating centers.
Disclosures
This is a summary of a preprint research study "Is radioiodine ablation with 30 mCi 131I necessary in low-risk thyroid cancer patients? Results from a long-term follow-up prospective study," by researchers at several centers in Buenos Aires, Argentina, published on Research Square and provided to you by Medscape. The study has not yet been peer-reviewed. The full text of the study can be found on researchsquare.com.
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Radioiodine's Benefit Absent in Low-Risk Thyroid Cancer - Medscape
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