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Clinicopathologic risk factors of radioactive iodine therapy based on response assessment in patients with differentiated thyroid cancer: a multicenter retrospective cohort study.

Authors :
Kwon, Seong Young
Lee, Sang-Woo
Kong, Eun Jung
Kim, Keunyoung
Kim, Byung Il
Kim, Jahae
Kim, Heeyoung
Park, Seol Hoon
Park, Jisun
Park, Hye Lim
Oh, So Won
Won, Kyoung Sook
Ryu, Young Hoon
Yoon, Joon-Kee
Lee, Soo Jin
Lee, Jong Jin
Chong, Ari
Jeong, Young Jin
Jeong, Ju Hye
Cho, Young Seok
Source :
European Journal of Nuclear Medicine & Molecular Imaging. Mar2020, Vol. 47 Issue 3, p561-571. 11p. 2 Diagrams, 4 Charts.
Publication Year :
2020

Abstract

Purpose: We investigated whether predictive clinicopathologic factors can be affected by different response criteria and how the clinical usefulness of radioactive iodine (RAI) therapy should be evaluated considering variable factors in patients with differentiated thyroid carcinoma (DTC). Methods: A total of 1563 patients with DTC who underwent first RAI therapy after total or near total thyroidectomy were retrospectively enrolled from 25 hospitals. Response to therapy was evaluated with two different protocols based on combination of biochemical and imaging studies: (1) serum thyroglobulin (Tg) and neck ultrasonography (US) and (2) serum Tg, neck US, and radioiodine scan. The responses to therapy were classified into excellent and non-excellent or acceptable and non-acceptable to minimize the effect of non-specific imaging findings. We investigated which factors were associated with response to therapy depending on the follow-up protocols as well as response classifications. Multivariate logistic regression analysis was performed to identify factors significantly predicting response to therapy. Results: The proportion of patients in the excellent response group significantly decreased from 76.5 to 59.6% when radioiodine scan was added to the follow-up protocol (P < 0.001). Preparation method (recombinant human TSH vs. thyroid hormone withdrawal) was a significant factor for excellent response prediction evaluated with radioiodine scan (OR 2.129; 95% CI 1.687–2.685; P < 0.001) but was not for other types of response classifications. Administered RAI activity, which was classified as low (1.11 GBq) or high (3.7 GBq or higher), significantly predicted both excellent and acceptable responses regardless of the follow-up protocol. Conclusions: The clinical impact of factors related to response prediction differed depending on the follow-up protocol or classification of response criteria. A high administered activity of RAI was a significant factor predicting a favorable response to therapy regardless of the follow-up protocol or classification of response criteria. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
16197070
Volume :
47
Issue :
3
Database :
Academic Search Index
Journal :
European Journal of Nuclear Medicine & Molecular Imaging
Publication Type :
Academic Journal
Accession number :
141578526
Full Text :
https://doi.org/10.1007/s00259-019-04634-8