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Guiding the postoperative radioactive iodine-131 therapy for patients with papillary thyroid carcinoma according to the prognostic risk groups: a SEER-based study

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Abstract

Purpose

The effectiveness of iodine-131(131I) therapy in patients with papillary thyroid cancer (PTC) of various stage is controversial. This study aimed to use prognostic risk groups to guide 131I therapy in patients with PTC after radical thyroidectomy.

Methods

Data of 53,484 patients with PTC after radical thyroidectomy were collected from the Epidemiology and End Results (SEER) database. Patients were divided into subgroups according to MACIS system and regional lymph node involvement. The prognostic role of 131I therapy was investigated by comparing Kaplan–Meier survival analysis and Cox proportional hazard models in different subgroups.

Results

Sex, age, tumor size, invasion, regional lymph node involvement, and distant metastasis was related to the survival of patients with PTC. If MACIS < 7, 131I treatment didn’t affect the cancer-specific survival (CSS) rate. If MACIS ≥ 7, 131I therapy didn’t work on CSS rate for patients with N0 or N1a < 5 status; 131I therapy had improved CSS rate for patients in the N1a ≥ 5 or N1b status. If patients with distant metastasis, invasion, or large tumor, 131I therapy didn’t improve CSS rate for patients in N0 or N1a < 5 stage.

Conclusion

After radical thyroidectomy, if MACIS < 7, patients with PTC could avoid 131I therapy. If MACIS ≥ 7, patients in the N0 or N1a < 5 could avoid 131I therapy; those in the N1a ≥ 5 or N1b stage should be given 131I therapy. Among them, all patients with distant metastasis should be given 131I therapy.

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Data availability

Publicly available datasets were analyzed in this study. This data can be found here: http://appliedresearch.cancer.gov/seermedicare/.

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Funding

This work is supported by the WU JEIPING MEDICAL FOUNATION project (320.6750.2021-10-358 86), the KuanRen Excellent Doctor project (KY2019G016) of the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China, and Health Matters Technology Promotion of Chongqing (2020jsqd121).

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Authors and Affiliations

  1. Department of Breast and Thyroid Surgery, Army Specialty Medical Center, Chongqing, China

    Yuping Yang

  2. Department of Basic Medicine, Shanxi Medical University, Taiyuan, China

    Mingyu Gan

  3. The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Kun Yi

  4. Department of Breast and Thyroid Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Shanshan Han, Zijing Lin, Yanling Shi & Jia Ming

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  1. Yuping Yang
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  5. Zijing Lin
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  6. Yanling Shi
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  7. Jia Ming
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Contributions

Conceptualization: JM; Methodology: ZL; Software: YY; Validation: BZ and YS; Formal Analysis: YY, KY and SH; Data Curation: KY and SH; Writing – Original Draft Preparation: YY.; Writing – Review & Editing: JM and ZL; Visualization: BZ and YS; Supervision: JM; Project Administration: JM; Funding Acquisition: JM.

Corresponding author

Correspondence to Jia Ming.

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The authors have no conflicts of interest to report.

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Ethical review and approval were waived for this study, due to the data being publicly available and anonymous.

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Patient consent was waived due to the data being publicly available and anonymous.

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Yuping Yang and Mingyu Gan are co-first authors.

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Yang, Y., Gan, M., Yi, K. et al. Guiding the postoperative radioactive iodine-131 therapy for patients with papillary thyroid carcinoma according to the prognostic risk groups: a SEER-based study. J Cancer Res Clin Oncol 149, 17147–17157 (2023). https://doi.org/10.1007/s00432-023-05299-5

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