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Meta-Analysis
. 2022 Sep 6:2022:8028846.
doi: 10.1155/2022/8028846. eCollection 2022.

Radioactive Iodine Ablation Can Reduce the Structural Recurrence Rate of Intermediate-Risk Papillary Thyroid Microcarcinoma: A Meta-Analysis

Min Zhao #  1 , Xinyu Shi #  2 , Jing Zhang  1 , Shengming Deng  1 , Yeye Zhou  1 , Runze Wen  1 , Yixing Lu  1 , Bin Zhang  1
Affiliations
Meta-Analysis

Radioactive Iodine Ablation Can Reduce the Structural Recurrence Rate of Intermediate-Risk Papillary Thyroid Microcarcinoma: A Meta-Analysis

Min Zhao et al. Comput Math Methods Med. .

Abstract

Background: The incidence of papillary thyroid microcarcinoma (PTMC) has significantly increased in recent years, and the decision to use radioactive iodine (RAI) ablation in low-risk (LR) and intermediate-risk (IR) patients is controversial. The aim of this study was to evaluate whether RAI ablation can reduce the recurrence rate in LR-IR PTMC patients.

Methods: A comprehensive literature search of the PubMed, Embase, Cochrane Library, and Web of Science was conducted according to the PRISMA statement.

Results: There were 8 studies in English that fit our search strategy, and a total of 2847 patients were evaluated. The results of the meta-analysis showed RAI ablation in LR-IR PTMC patients did not reduce cancer recurrence (risk radio (RR) 0.56, 95% CI 0.19-1.70, P = 0.31). Nevertheless, we further performed data analysis and found that IR PTMC patients without RAI ablation had a higher rate of cancer recurrence than those who underwent RAI ablation (RR 0.23, 95% CI 0.11-0.49, P = 0.0001). Furthermore, patients with risk factors for lymph node metastasis (RR 0.16, 95% CI 0.06-0.42, P = 0.0002), microscopic extrathyroidal extension (RR 0.19, 95% CI 0.06-0.60, P = 0.005), and multifocality (RR 0.13, 95% CI 0.04-0.45, P = 0.001) in the absence of RAI ablation were more likely to have recurrence.

Conclusions: Based on our current evidence, RAI ablation can reduce the cancer recurrence rate over 5 years in IR PTMC patients, especially when patients have some risk factors, such as lymph node metastasis, microscopic extrathyroidal extension, and multifocality.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of study selection.
Figure 2
Figure 2
A forest plots that details any recurrence in LR-IR PTMC patients.
Figure 3
Figure 3
A forest plots that details the locoregional recurrence in LR-IR PTMC patients.
Figure 4
Figure 4
A forest plots that details the recurrence in patients with IR PTMC.
Figure 5
Figure 5
A forest plots that details the recurrence in PTMC patients with some risk factors (lymph node metastasis, microscopic extrathyroidal extension, and multifocality).
Figure 6
Figure 6
Funnel plot. SE: standard error; RR: risk radio.
See this image and copyright information in PMC

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