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Clin. Nucl. Med., May 09 2025, | https://doi.org/10.1097/RLU.0000000000005940
Impact of Therapeutic Radioactive Iodine on the Recurrence of Papillary Thyroid Cancer With Extranodal Extension in Metastatic Lymph Nodes: A Propensity Score-matched Analysis
Kim, Hye In PhD*; Kim, Boram MD†; Hyeon, Jiyeon MD‡; Ko, Nak Gyeong MSc§; Jin, Mihyeon MSc§; Cho, Jung Hwan MD*; Han, Ji Min PhD*; Suh, Sunghwan PhD*; Bae, Ji Cheol PhD*; Chung, Man Ki PhD∥; Choe, Jun-Ho PhD¶; Kim, Sun Wook PhD†; Chung, Jae Hoon PhD†; Oh, Young Lyun PhD‡; Kim, Kyunga PhD#; Kim, Tae Hyuk PhD†; Choi, Joon Young PhD**
*Department of Medicine, Division of Endocrinology and Metabolism, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon
†Department of Medicine, Division of Endocrinology & Metabolism, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine
‡Department of Medicine, Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
§Department of Research & Support, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon
∥Department of Otorhinolaryngology-Head and Neck Surgery
¶Department of Surgery, Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine
#Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center
**Department of Nuclear Medicine, and Molecular Imaging, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
H.I.K. and B.K. contributed equally to this study.
Correspondence to: Tae Hyuk Kim, MD, PhD ; Joon Young Choi, MD, PhD
*Department of Medicine, Division of Endocrinology and Metabolism, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon
†Department of Medicine, Division of Endocrinology & Metabolism, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine
‡Department of Medicine, Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
§Department of Research & Support, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon
∥Department of Otorhinolaryngology-Head and Neck Surgery
¶Department of Surgery, Division of Breast and Endocrine Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine
#Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center
**Department of Nuclear Medicine, and Molecular Imaging, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
H.I.K. and B.K. contributed equally to this study.
Correspondence to: Tae Hyuk Kim, MD, PhD ; Joon Young Choi, MD, PhD
Abstract
Purpose: Radioactive iodine therapy (RAI) ≥100 mCi (3.7 GBq) is commonly recommended for papillary thyroid cancer (PTC) patients with extranodal extension (ENE). However, no study has evaluated whether RAI ≥100 mCi is effective in reducing the recurrence of PTC with ENE.
Methods: This retrospective cohort study enrolled 191 PTC patients with ENE who underwent total thyroidectomy and RAI. Recurrence according to RAI activity (<100 vs. ≥100 mCi) was compared before and after propensity score matching (PSM) (1:2) using Kaplan-Meier curves and Cox proportional hazards regression models. Subgroup analyses according to mass size (<4 and ≥4 cm), gender, blood vessel invasion, lymph node (LN) number (≤5 and >5), and stimulated Tg (sTg) level (<10 and ≥10 ng/mL) before and after PSM were performed.
Results: During about 116 months, 5 (12.5%) and 19 (12.6%) before PSM, five (12.5%) and 3 (3.8%) after PSM recorded recurrence in <100 and ≥100 mCi groups, respectively. The impact of RAI ≥100 mCi on reducing recurrence was not significant before [log-rank P = 0.915, adjusted hazard ratio (HR) 0.49 (0.12-1.85); P = 0.294) and after PSM (log-rank P = 0.077). Subgroup analysis after PSM demonstrated the impact of RAI ≥100 mCi on lowering recurrence only in ENE patients with mass size ≥4 cm (log-rank P = 0.008), LN >5 (log-rank P = 0.007), and sTg ≥10 ng/mL (log-rank P = 0.039).
Conclusions: In PTC patients with ENE, mass size ≥4 cm, LN >5, or sTg ≥10 ng/mL had a benefit from RAI ≥100 mCi compared with RAI <100 mCi.
Methods: This retrospective cohort study enrolled 191 PTC patients with ENE who underwent total thyroidectomy and RAI. Recurrence according to RAI activity (<100 vs. ≥100 mCi) was compared before and after propensity score matching (PSM) (1:2) using Kaplan-Meier curves and Cox proportional hazards regression models. Subgroup analyses according to mass size (<4 and ≥4 cm), gender, blood vessel invasion, lymph node (LN) number (≤5 and >5), and stimulated Tg (sTg) level (<10 and ≥10 ng/mL) before and after PSM were performed.
Results: During about 116 months, 5 (12.5%) and 19 (12.6%) before PSM, five (12.5%) and 3 (3.8%) after PSM recorded recurrence in <100 and ≥100 mCi groups, respectively. The impact of RAI ≥100 mCi on reducing recurrence was not significant before [log-rank P = 0.915, adjusted hazard ratio (HR) 0.49 (0.12-1.85); P = 0.294) and after PSM (log-rank P = 0.077). Subgroup analysis after PSM demonstrated the impact of RAI ≥100 mCi on lowering recurrence only in ENE patients with mass size ≥4 cm (log-rank P = 0.008), LN >5 (log-rank P = 0.007), and sTg ≥10 ng/mL (log-rank P = 0.039).
Conclusions: In PTC patients with ENE, mass size ≥4 cm, LN >5, or sTg ≥10 ng/mL had a benefit from RAI ≥100 mCi compared with RAI <100 mCi.
논문정보
- Research article
- 2025년 05월 (BRIC 등록일 2025-05-14)
- 국내 연구진
- 의약학 > 응용의학
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