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Comparative Study
. 2019 Nov;89(11):E502-E506.
doi: 10.1111/ans.15522. Epub 2019 Oct 31.

Radioactive iodine ablation post differentiated thyroid cancer surgery: an analysis of use and impact of the American Thyroid Association guidelines

Yi Sia  1 , Rajiv V Dave  1 , Daniel Nour  1 , Julie A Miller  1   2 , Anita R Skandarajah  1   2 , Robert Tasevski  1   2
Affiliations
Comparative Study

Radioactive iodine ablation post differentiated thyroid cancer surgery: an analysis of use and impact of the American Thyroid Association guidelines

Yi Sia et al. ANZ J Surg. 2019 Nov.

Abstract

Background: The 2009 American Thyroid Association (ATA) three-tiered risk stratification, and its updated version in 2015, provided clearer guidance on the use of radioactive iodine (RAI) ablation in differentiated thyroid cancer (DTC) patients. This study examines the impact of these guidelines on RAI use in our institution.

Methods: Patients diagnosed with DTC during three different time periods (group 1: 2002-2006, group 2: 2010-2014 and group 3: 2017-2018) were identified and risk stratified according to the ATA guidelines. RAI use and extent of surgery were compared between the three groups. Categorical variables were analysed using Fisher's exact (2 × 2) and chi-squared (>2 × 2) tests.

Results: A total of 415 patients were included (group 1 = 88, group 2 = 215, group 3 = 112). The proportion of patients having total thyroidectomy were 84.6, 84.7 and 69.6% in groups 1, 2 and 3, respectively (P = 0.003). Central lymph node dissection was significantly higher in the more contemporary groups compared to group 1 (9.1 versus 41.9 versus 64.3%, P < 0.001). Overall, fewer patients received RAI in more recent times (76.6 versus 54.8 versus 26.8%, P < 0.001), most evident in the low-risk patients (70 versus 29.1 versus 5.1%, P < 0.001). In the high risk group, the majority received RAI, with no difference between the groups.

Conclusion: Comparing DTC patients treated in our unit before and after publications of the 2009 and 2015 ATA guidelines, more nodal surgery was performed with less RAI administered in the latter groups. Better risk stratification according to the ATA guidelines has allowed more judicious use of RAI ablation.

Keywords: American Thyroid Association guidelines; differentiated thyroid cancer; radioactive iodine ablation.

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References

    1. Sherman SI. Thyroid carcinoma. Lancet 2003; 361: 501-11.
    1. Sciuto R, Romano L, Rea S, Marandino F, Sperduti I, Maini CL. Natural history and clinical outcome of differentiated thyroid carcinoma: a retrospective analysis of 1503 patients treated at a single institution. Ann. Oncol. 2009; 20: 1728-35.
    1. Podnos YD, Smith D, Wagman LD, Ellenhorn JD. The implication of lymph node metastasis on survival in patients with well-differentiated thyroid cancer. Am. Surg. 2005; 71: 731-4.
    1. Wang Q, Chu B, Zhu J et al. Clinical analysis of prophylactic central neck dissection for papillary thyroid carcinoma. Clin. Transl. Oncol. 2014; 16: 44-8.
    1. Cooper DS, Doherty GM, Haugen BR et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. The American Thyroid Association guidelines taskforce on thyroid nodules and differentiated thyroid Cancer. Thyroid 2009; 19: 1167-214.

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