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首页> 外文期刊>Endocrine-related cancer >Radioactive iodine ablation may not decrease the risk of recurrence in intermediate-risk papillary thyroid carcinoma
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Radioactive iodine ablation may not decrease the risk of recurrence in intermediate-risk papillary thyroid carcinoma

机译：放射性碘消融可能不会降低中度危险性甲状腺乳头状癌的复发风险

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The use of radioactive iodine (RAI) ablation in patients with intermediate-risk papillary thyroid carcinoma (PTC) who show microscopic extrathyroidal extension (ETE), regional lymph node (LN) metastasis, tumors with aggressive histology, or vascular invasion has been debated due to the lack of data regarding long-term prognosis in this risk group. Therefore, the purpose of this study was to resolve the controversy surrounding the prognostic benefit of RAI ablation, especially in intermediate-risk PTC patients. We retrospectively reviewed the medical records of 8297 intermediate-risk PTC patients who underwent primary total thyroidectomy with or without neck dissection at the Thyroid Cancer Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, between January 1997 and June 2015. Of these 8297 patients, 7483 (90.2%) received RAI ablation. After adjusting for clinicopathological characteristics, RAI ablation did not significantly decrease the risk of loco-regional recurrence (LRR) (adjusted hazard ratio (HR)?0.852, P?0.413). Moreover, RAI ablation did not decrease the risk of LRR even in intermediate-risk PTC patients with aggressive features such as BRAF positivity (adjusted HR?0.729, P?0.137), tumor size 1 cm (adjusted HR?0.762, P?0.228), multifocality (adjusted HR?1.032, P?0.926), ETE (adjusted HR?0.870, P?0.541), and regional LN metastasis (adjusted HR?0.804, P?0.349). Furthermore, high-dose RAI ablation (100 mCi) did not significantly decrease the risk of LRR (adjusted HR?0.942, P?0.843). Therefore, RAI ablation in intermediate-risk PTC patients should be considered on the basis of tailored risk restratification.
机译：对于中度甲状腺乳头状甲状腺癌（PTC）表现为镜下甲状腺外扩张（ETE），局部淋巴结（LN）转移，具有侵袭性组织学或血管侵犯的肿瘤的中度危险的甲状腺癌患者，使用放射性碘（RAI）消融已引起争议缺乏有关该风险组的长期预后的数据。因此，本研究的目的是解决有关RAI消融预后获益的争议，尤其是在中危PTC患者中。我们回顾性分析了1997年1月至2015年6月在韩国首尔成均馆大学医学院三星医学中心甲状腺癌中心进行的8297例初次全甲状腺切除术并伴或不伴有颈淋巴结清扫术的中危PTC患者的病历。在这8297名患者中，有7483名（90.2％）接受了RAI消融。在调整了临床病理特征后，RAI切除并未显着降低局部复发（LRR）的风险（调整后的危险比（HR）≤0.852，P≤0.413）。而且，即使在具有BRAF阳性（校正后的HR≥0.729，P≤0.137），肿瘤大小> 1 cm（校正后的HR≥0.762，P≤0.228）等侵袭性特征的中危PTC患者中，RAI切除也不能降低LRR的风险。 ），多焦点（调整后的HR？1.032，P？0.926），ETE（调整后的HR？0.870，P？0.541）和局部LN转移（调整后的HR？0.804，P？0.349）。此外，大剂量RAI消融（> 100 mCi）并未显着降低LRR的风险（校正后的HR？0.942，P？0.843）。因此，应根据有针对性的风险重新调整，考虑对中度风险PTC患者进行RAI消融。

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