Selective postoperative radioactive iodine treatment of thyroid carcinoma

Treatment of thyroid cancer is primarily surgical, usually consisting of thyroidectomy (removal of the thyroid gland) and dissection of the neck with removal of cervical lymph nodes. Also used are hormone replacement therapy, suppression of thyroid stimulating hormone (TSH), and I-131 (radioactive iodine) scanning and treatment. A report is presented of 25 years' experience using I-131 scanning and treatment for thyroid cancer in 234 patients. There were three groups of patients studied prospectively: group 1, 21 patients with 3 percent or more uptake of I-131; group 2, 44 patients with less than 3 percent uptake; and group 3, 169 patients without evidence of cancer spread who were treated with only thyroid hormone. Initially, all patients had thyroidectomy and neck dissection. Tumor recurrence was found in four patients (three in group 1 and one in group 2); average follow-up for these groups was 8.9 and 8.4 years, respectively. Group three had an average follow-up of 7.2 years with no tumor recurrences. Groups 2 and 3 had no deaths; group 1 had a 5 percent mortality (one patient) from thyroid cancer. These results indicate that patients with thyroid cancer who do not have tumor extension or distant cancer spread can safely be treated with only surgery and thyroid hormone, and do not benefit from scanning and treatment with I-131. (Consumer Summary produced by Reliance Medical Information, Inc.)