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Optimal Timing of Initiating Dynamic Risk Stratification During the Early Postoperative Period in Patients with Differentiated Thyroid Carcinoma After Thyroidectomy and Radioactive Iodine Remnant Ablation

  • Endocrine Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

This study investigated the optimal timing to initiate assessment of the response to initial therapy during the early postoperative period in patients with differentiated thyroid carcinoma (DTC) using dynamic risk stratification (DRS).

Methods

This historical cohort study included 510 patients with DTC who underwent a total thyroidectomy followed by radioactive iodine (RAI) remnant ablation. DRS for these patients was categorized into subgroups according to the time into the follow-up period at which the response to initial therapy was assessed. The ability of each DRS subgroup to predict the long-term structural recurrence of cancer was compared using the proportion of variance explained (PVE) from logistic regression models.

Results

The median follow-up period was 108 months. Structural recurrence occurred in 7.6% of patients (n = 39/510). The PVE for long-term structural recurrence was higher among DRS subgroups (28.8–34.19%) compared with the American Joint Committee on Cancer/Union for International Cancer Control tumor-node-metastasis staging system (both the 7th and 8th editions; 4.01% and 6.13%, respectively) and the American Thyroid Association initial risk estimate (4.59%). Among the DRS subgroups, DRS assessed between 2 and 3 years after the initial surgery was associated with the highest PVE (34.19%).

Conclusions

The first assessment of DRS optimally predicts long-term structural recurrence in patients with DTC who underwent a total thyroidectomy and subsequent RAI remnant ablation at that 2- to 3-year postoperative period.

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Department of Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, South Korea

    Jae Hyun Park MD, PhD, Gil Seong Moon MD, Kyung Tae Nam MD & Jong Ho Yoon MD, PhD

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  1. Jae Hyun Park MD, PhD
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  2. Gil Seong Moon MD
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  3. Kyung Tae Nam MD
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  4. Jong Ho Yoon MD, PhD
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Corresponding author

Correspondence to Jong Ho Yoon MD, PhD.

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Jae Hyun Park, Gil Seong Moon, Kyung Tae Nam, and Jong Ho Yoon declare that no competing financial interests exist.

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Park, J.H., Moon, G.S., Nam, K.T. et al. Optimal Timing of Initiating Dynamic Risk Stratification During the Early Postoperative Period in Patients with Differentiated Thyroid Carcinoma After Thyroidectomy and Radioactive Iodine Remnant Ablation. Ann Surg Oncol 28, 6580–6589 (2021). https://doi.org/10.1245/s10434-021-09721-5

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  • DOI: https://doi.org/10.1245/s10434-021-09721-5

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