Radioactive iodine therapy helps prevent papillary thyroid cancer recurrence

Patients with unstimulated thyroglobulin (Tg) ≤1 ng/mL or stimulated Tg ≤10 ng/mL who receive radioactive iodine therapy (RAIT) may benefit from a lower recurrence risk of intermediate-risk papillary thyroid cancer (PTC), reveals a study.

A total of 1,487 patients with intermediate-risk PTC with unstimulated Tg ≤1 ng/mL or stimulated Tg ≤10 ng/mL following total thyroidectomy were included in this study.

The authors compared the clinicopathological characteristics between the RAIT and non-RAIT groups before and after propensity score matching (PSM). They also assessed the effect of RAIT on biochemical recurrence and structural recurrence.

Of the patients, 1,349 (90.7 percent) underwent RAIT, and 138 (9.3 percent) did not. Thirty patients had recurrence, including 11 structural and 19 biochemical recurrences, after a median follow-up time of 51 months. After PSM, patients in the non-RAIT group were more likely to have structural (5/138 vs 5/552; p=0.046) and biochemical recurrences (6/138 vs 4/552; p=0.005) than those in the RAIT group.

In multivariate analysis, not receiving RAIT is independently associated with a higher risk for structural recurrence (hazard ratio [HR], 10.572, 95 percent confidence interval [CI], 2.439‒45.843; p=0.002) and biochemical recurrences (HR, 16.568, 95 percent CI, 3.670‒74.803; p<0.001).

Additionally, Kaplan‒Meier analysis revealed more unfavourable recurrence-free survival among patients who did not receive RAIT (structural and biochemical: p<0.05 for all).

“Further prospective randomized studies are needed to confirm these findings,” the authors.