ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P681

Radioactive iodide therapy for high-risk papillary thyroid carcinoma

Jen-Der Lin, Kun-Ju Lin, Tzu-Chieh Chao & Chuen Hseuh

Chang Gung Memorial Hospital, Taoyuan Hsien, Taiwan, Province of China.

Radioactive iodide (131I) is an effective treatment modality for papillary and follicular thyroid carcinomas. This retrospective study analyzed the role of 131I therapy in high-risk papillary thyroid carcinoma patients after surgical thyroid removal.

Methods: The study analyzed 1055 consecutive high-risk papillary thyroid cancer patients, including 825 females and 230 males who underwent near-total or total thyroidectomy and follow up at one Medical Center in Taiwan. Patients were categorized into four groups according to treatment outcome. Group A included disease-free patients defined as those with negative 131I whole body scan and lacking serum thyroglobulin (Tg), Tg antibody and recurrence. Group B included non-relapse patients defined as those with no clinical evidence of persistent or recurrent thyroid cancer. Group C included patients with persistent disease defined as those with cancer tissue persisting after surgery. Group D included patients suffering recurrence defined as cancer recurrence after surgery and 131I ablation.

Results: After a mean follow-up period of 10.1±5.4 years (median: 9.5 years), forty-six (4.36%) patients died of thyroid cancer. Nine group A cases with persistent or recurrent cancer were treated until achieving disease-free status. Group C patients received the highest 131I dose but had 25.7% mortality rate. In group D, four of fifty-six (7.1%) patients with recurrent local neck cancer died of thyroid cancer. Conversely, twelve of fifty-six (21.4%) cases died of thyroid cancer with distant metastases.

Conclusions: Radioactive iodide effectively controlled papillary thyroid carcinoma after thyroid ablation in 23.9% of high-risk patients. After surgery and 131I treatments most cases of persistent or recurrent local-regional neck cancer were effectively controlled in a relapse-free status with a cancer mortality rate of 19.0%.

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