Radioactive iodine overused in low-risk thyroid cancer

  • Moten AS & al.
  • Surg Oncol
  • 1 Jun 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Age, sex, race, insurance status, and extent of surgery are associated with postsurgical radioactive iodine (RAI) ablation in patients with low-risk papillary thyroid cancer (PTC).

Why this matters

  • Postsurgical RAI is not indicated for low-risk patients under American Thyroid Association (ATA) guidelines.

Key results

  • 25% of patients with low-risk PTC received RAI.
  • Risk factors for postsurgical RAI in low-risk PTC:
    • Age
    • Male sex (OR, 1.191; 95% CI, 1.086-1.305).
    • Hispanic (OR, 1.236; 95% CI, 1.110-1.376) or Asian race (OR, 1.306; 95% CI, 1.159-1.473).
    • Number of lymph nodes removed (OR, 1.090; 95% CI, 1.003-1.184 for 1-3; OR, 1.243; 95% CI, 1.119-1.381 for ≥4).
    • Total/near total thyroidectomy (OR, 5.823; 95% CI, 5.036-6.734).
  • Black race (OR, 0.851; 95% CI, 0.733-0.987) and unknown insurance status (OR, 0.503; 95% CI, 0.374-0.676) were inversely associated with postsurgical RAI in patients with low-risk PTC.

Study design

  • 32,229 patients with PTC, 53.6% classified as low risk (T1 without metastasis), were analyzed for factors associated with postsurgical RAI.
  • Funding: None.

Limitations

  • Retrospective study of large database.