PDF(Pubmed)
Abstract：
UNASSIGNED: In differentiated thyroid cancer (DTC), radioiodine (RAI) therapy is most frequently employed for remnant ablation or as adjuvant therapy for the remaining disease. The application of RAI to patients classified as intermediate risk (InR) is still a matter of debate. The aim of this study is to analyze the effect of early postoperative risk assessment on RAI use on papillary thyroid cancer patients who are classified as low risk (LoR) or InR.
UNASSIGNED: This is a single-center, prospective registry study. One-hundred-eighty-six patients operated between January 2012 and August 2021 and categorized as LoR or InR were included in this study. All patients had total thyroidectomy and central lymph node dissection by the same endocrine surgeon. An early dynamic risk assessment (EDRA) consisting of neck ultrasonography, serum thyroglobulin (Tg) and anti-Tg levels was performed 6 weeks after surgery. Most of the patients were either followed up without RAI or received ablative low activity (30-50 mCi) RAI based on predetermined criteria.
UNASSIGNED: Median follow-up was 63 months. Sixty-six (61%) patients in the LoR group and 43 (56%) patients in the InR group did not receive RAI treatment. Thirty-eight (35%) and 22 (29%) patients in LoR and InR groups received ablative (30-50 mCi) RAI therapy, respectively. In LoR group 5 (4.6%) patients and in InR group 12 (16%) patients received 100 mCi or more RAI activity. Only one patient in the InR group recurred during follow-up. No statistically significant difference regarding local recurrence was found between patients who didn\'t receive RAI or were treated with RAI within both LoR (p=0.152) and InR (p=0.272) groups.
UNASSIGNED: There is consensus for LoR patients about omitting RAI therapy after surgery. Indications for RAI treatment in InR DTC are still under debate. RAI use based on EDRA seems to be a better option than decisions solely made on histopathological risk factors and decreases adjuvant high-activity RAI use without increasing recurrence risk.
UNASSIGNED: This is a single-center, prospective registry study. One-hundred-eighty-six patients operated between January 2012 and August 2021 and categorized as LoR or InR were included in this study. All patients had total thyroidectomy and central lymph node dissection by the same endocrine surgeon. An early dynamic risk assessment (EDRA) consisting of neck ultrasonography, serum thyroglobulin (Tg) and anti-Tg levels was performed 6 weeks after surgery. Most of the patients were either followed up without RAI or received ablative low activity (30-50 mCi) RAI based on predetermined criteria.
UNASSIGNED: Median follow-up was 63 months. Sixty-six (61%) patients in the LoR group and 43 (56%) patients in the InR group did not receive RAI treatment. Thirty-eight (35%) and 22 (29%) patients in LoR and InR groups received ablative (30-50 mCi) RAI therapy, respectively. In LoR group 5 (4.6%) patients and in InR group 12 (16%) patients received 100 mCi or more RAI activity. Only one patient in the InR group recurred during follow-up. No statistically significant difference regarding local recurrence was found between patients who didn\'t receive RAI or were treated with RAI within both LoR (p=0.152) and InR (p=0.272) groups.
UNASSIGNED: There is consensus for LoR patients about omitting RAI therapy after surgery. Indications for RAI treatment in InR DTC are still under debate. RAI use based on EDRA seems to be a better option than decisions solely made on histopathological risk factors and decreases adjuvant high-activity RAI use without increasing recurrence risk.
摘要：
■在分化型甲状腺癌（DTC）中，放射性碘（RAI）治疗最常用于残余消融或作为其余疾病的辅助治疗。RAI在被归类为中等风险（InR）的患者中的应用仍存在争议。这项研究的目的是分析术后早期风险评估对RAI使用的影响，这些患者被归类为低风险（LoR）或InR。
■这是一个单中心，前瞻性注册研究。本研究包括2012年1月至2021年8月间进行手术的186例患者，分为LoR或InR。所有患者均由同一内分泌外科医生进行甲状腺全切除术和中央区淋巴结清扫术。早期动态风险评估（EDRA）包括颈部超声检查，术后6周测定血清甲状腺球蛋白(Tg)和抗Tg水平.根据预定标准，大多数患者要么在没有RAI的情况下进行随访，要么接受消融性低活性（30-50mCi）RAI。
■中位随访时间为63个月。LoR组中有66例（61％）患者和InR组中有43例（56％）患者未接受RAI治疗。LoR和InR组中的38例（35％）和22例（29％）患者接受了消融性（30-50mCi）RAI治疗，分别。在LoR组5（4.6％）患者和InR组12（16％）患者接受了100mCi或更多的RAI活性。InR组中只有一名患者在随访期间复发。在LoR（p=0.152）和InR（p=0.272）组中，未接受RAI或接受RAI治疗的患者的局部复发无统计学差异。
■LoR患者对手术后省略RAI治疗有共识。InRDTC中RAI治疗的适应症仍在争论中。使用基于EDRA的RAI似乎比仅根据组织病理学危险因素做出的决定更好，并且可以减少辅助高活性RAI的使用而不会增加复发风险。
■这是一个单中心，前瞻性注册研究。本研究包括2012年1月至2021年8月间进行手术的186例患者，分为LoR或InR。所有患者均由同一内分泌外科医生进行甲状腺全切除术和中央区淋巴结清扫术。早期动态风险评估（EDRA）包括颈部超声检查，术后6周测定血清甲状腺球蛋白(Tg)和抗Tg水平.根据预定标准，大多数患者要么在没有RAI的情况下进行随访，要么接受消融性低活性（30-50mCi）RAI。
■中位随访时间为63个月。LoR组中有66例（61％）患者和InR组中有43例（56％）患者未接受RAI治疗。LoR和InR组中的38例（35％）和22例（29％）患者接受了消融性（30-50mCi）RAI治疗，分别。在LoR组5（4.6％）患者和InR组12（16％）患者接受了100mCi或更多的RAI活性。InR组中只有一名患者在随访期间复发。在LoR（p=0.152）和InR（p=0.272）组中，未接受RAI或接受RAI治疗的患者的局部复发无统计学差异。
■LoR患者对手术后省略RAI治疗有共识。InRDTC中RAI治疗的适应症仍在争论中。使用基于EDRA的RAI似乎比仅根据组织病理学危险因素做出的决定更好，并且可以减少辅助高活性RAI的使用而不会增加复发风险。
