Long-term clinical outcomes and prognostic factors for patients with papillary thyroid carcinoma with other organ invasions after adjuvant radioactive iodine

Endocrine. 2023 Apr;80(1):79-85. doi: 10.1007/s12020-022-03251-0. Epub 2022 Nov 11.

Abstract

Purpose: Papillary thyroid carcinoma (PTC) with other organ invasions is directly related to patient prognosis and quality of life; however, studies on the clinical outcomes of adjuvant radioactive iodine (RAI) for PTC with other organ invasions are limited. This study aimed to clarify the clinical outcomes and prognostic factors for patients with PTC with other organ invasions after adjuvant RAI.

Methods: Patients with PTC with other organ invasions without distant metastases who underwent surgery and adjuvant RAI were retrospectively reviewed. We evaluated the initial responses based on the American Thyroid Association guidelines and survival rates. Prognostic factors for locoregional recurrence-free survival (LRRFS) were analyzed.

Results: Between January 2005 and December 2019, 102 patients were included in the study. Their median age was 55 years. The median follow-up duration was 92 months (range; 30-231 months). The excellent response rate after RAI was 42%. The 7-year overall survival, LRRFS, and recurrence-free survival rates were 100%, 75%, and 75%, respectively. Metastatic lymph node size, resection margin status, and post-RAI suppressed thyroglobulin level were the independent prognostic factors for LRRFS.

Conclusion: We demonstrated that 75% of patients with PTC with other organ invasions could achieve long-term survival without recurrence after adjuvant RAI. Future development of effective treatment strategies for large metastatic lymph nodes, gross residual tumors, and high serum thyroglobulin levels is warranted.

Keywords: Extra-capsular extension; Positive tumor margin; Radioiodine therapy; Thyroid cancer; Thyroidectomy.

MeSH terms

  • Carcinoma, Papillary* / drug therapy
  • Carcinoma, Papillary* / radiotherapy
  • Carcinoma, Papillary* / surgery
  • Humans
  • Iodine Radioisotopes / therapeutic use
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy
  • Prognosis
  • Quality of Life
  • Retrospective Studies
  • Thyroglobulin
  • Thyroid Cancer, Papillary / radiotherapy
  • Thyroid Cancer, Papillary / surgery
  • Thyroid Neoplasms* / radiotherapy
  • Thyroid Neoplasms* / surgery
  • Thyroidectomy

Substances

  • Thyroglobulin
  • Iodine Radioisotopes