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Clinicopathologic risk factors of radioactive iodine therapy based on response assessment in patients with differentiated thyroid cancer: a multicenter retrospective cohort study

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Author(s)
Seong Young KwonSang-Woo LeeEun Jung KongKeunyoung KimByung Il KimJahae KimHeeyoung KimSeol Hoon ParkJisun ParkHye Lim ParkSo Won OhKyoung Sook WonYoung Hoon RyuJoon-Kee YoonSoo Jin LeeJong Jin LeeAri ChongYoung Jin JeongJu Hye JeongYoung Seok ChoArthur ChoGi Jeong CheonEun Kyoung ChoiJae Pil HwangSang Kyun Bae
Keimyung Author(s)
Won, Kyoung Sook
Department
Dept. of Nuclear Medicine (핵의학)
Journal Title
European journal of nuclear medicine and molecular imaging.
Issued Date
2019
Volume
47
Issue
3
Keyword
Differentiated thyroid carcinomaRadioactive iodine therapyRecombinant human thyrotropinResponse to therapy.
Abstract
Purpose:
We investigated whether predictive clinicopathologic factors can be affected by different response criteria and how the clinical usefulness of radioactive iodine (RAI) therapy should be evaluated considering variable factors in patients with differentiated thyroid carcinoma (DTC).

Methods:
A total of 1563 patients with DTC who underwent first RAI therapy after total or near total thyroidectomy were retrospectively enrolled from 25 hospitals. Response to therapy was evaluated with two different protocols based on combination of biochemical and imaging studies: (1) serum thyroglobulin (Tg) and neck ultrasonography (US) and (2) serum Tg, neck US, and radioiodine scan. The responses to therapy were classified into excellent and non-excellent or acceptable and non-acceptable to minimize the effect of non-specific imaging findings. We investigated which factors were associated with response to therapy depending on the follow-up protocols as well as response classifications. Multivariate logistic regression analysis was performed to identify factors significantly predicting response to therapy.

Results:
The proportion of patients in the excellent response group significantly decreased from 76.5 to 59.6% when radioiodine scan was added to the follow-up protocol (P < 0.001). Preparation method (recombinant human TSH vs. thyroid hormone withdrawal) was a significant factor for excellent response prediction evaluated with radioiodine scan (OR 2.129; 95% CI 1.687-2.685; P < 0.001) but was not for other types of response classifications. Administered RAI activity, which was classified as low (1.11 GBq) or high (3.7 GBq or higher), significantly predicted both excellent and acceptable responses regardless of the follow-up protocol.

Conclusions:
The clinical impact of factors related to response prediction differed depending on the follow-up protocol or classification of response criteria. A high administered activity of RAI was a significant factor predicting a favorable response to therapy regardless of the follow-up protocol or classification of response criteria.
Keimyung Author(s)(Kor)
원경숙
Publisher
School of Medicine (의과대학)
Citation
Seong Young Kwon et al. (2019). Clinicopathologic risk factors of radioactive iodine therapy based on response assessment in patients with differentiated thyroid cancer: a multicenter retrospective cohort study. European journal of nuclear medicine and molecular imaging., 47(3), 561–571. doi: 10.1007/s00259-019-04634-8
Type
Article
ISSN
1619-7089
Source
https://link.springer.com/article/10.1007%2Fs00259-019-04634-8
DOI
10.1007/s00259-019-04634-8
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42630
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학)
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