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Incidence rate and factors associated with the development of secondary cancers after radioiodine therapy in differentiated thyroid cancer: a multicenter retrospective study

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Abstract

Purpose

The objective of this study was to estimate the incidence of secondary cancers and the factors associated with their development among patients who underwent radioiodine therapy (RIT) with differentiated thyroid cancer.

Methods

We retrospectively collected medical records for patients who underwent first RIT between January 1, 2000, and December 31, 2005, from seven tertiary hospitals in South Korea after total thyroidectomy for differentiated thyroid cancer. Cancer incidence and calculated standardized rate ratio were compared with Korean cancer incidence data. The association between the development of secondary cancers and various parameters was analyzed by Cox-proportional hazard regression.

Results

A total of 3106 patients were included in this study. Mean age at the time of diagnosis of thyroid cancer was 45.7 ± 13.3 years old, and 2669 (85.9%) patients were female. The follow-up period was 11.9 ± 4.6 (range, 1.2–19.6) years. A total of 183 secondary cancers, which included 162 solid and 21 hematologic cancers, occurred in 173 patients (5.6%). There was no significant difference between solid cancer incidence in our study population who underwent RIT and the overall Korean population, but the incidence of hematologic cancers and total cancer in our study was significantly higher compared with that of the Korean population. A multivariate analysis identified independent prognostic factors for the development of secondary cancer including age at 1st RIT, male, and total cumulative dose over 200 mCi.

Conclusion

We need to assess the risk benefit for patients who receive over 200 mCi of a total cumulative dose.

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Funding

This work was supported by the Korean Thyroid Association Clinical Research Award 2019.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, School of Medicine, Kyungpook National University, 130 Dongdeok-ro, Jung-gu, 41944, Daegu, Republic of Korea

    Chae Moon Hong, Shin Young Jeong, Sang-Woo Lee & Jaetae Lee

  2. Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Korea

    Ji-Yeon Shin

  3. Department of Nuclear Medicine, Korea Atomic Energy Research Institute, Seoul, Korea

    Byeong Il Kim

  4. Department of Nuclear Medicine, School of Medicine, Chonnam National University Medical School, Gwangju, Korea

    Ho-Chun Song

  5. Department of Nuclear Medicine & Molecular Imaging, Ajou University School of Medicine, Suwon, Korea

    Joon-Kee Yoon

  6. Department of Nuclear Medicine, School of Medicine, Keimyung University, Daegu, Korea

    Kyoung Sook Won

  7. Department of Nuclear Medicine, School of Medicine, Chungnam National University, Daejeon, Korea

    Seong-Min Kim

  8. Department of Nuclear Medicine, School of Medicine, Yeungnam University, Daegu, Korea

    Ihn Ho Cho

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  1. Chae Moon Hong
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Contributions

C.M.H. and J.L. performed the study design, and J.L contributed for funding resources. C.M.H., J-Y.S., S.Y.J., and S-W.L. performed the data analysis. J-Y.S. contributed statistical assistance and review. C.M.H. and J.L. wrote the initial draft, and B.I.K., H-C.S., J-K.Y., K.S.W., S-M.K., and I.H.C. contributed for data collection and review of the manuscript.

Corresponding author

Correspondence to Jaetae Lee.

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The Institutional Review board approved this study.

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Informed consent was waived by the Institutional Review Board.

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Patients signed an informed consent which was waived by Institutional Review Board.

Conflict of interest

The authors declare no competing interests.

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This article is part of the Topical Collection on Oncology - Head and Neck

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Hong, C.M., Shin, JY., Kim, B.I. et al. Incidence rate and factors associated with the development of secondary cancers after radioiodine therapy in differentiated thyroid cancer: a multicenter retrospective study. Eur J Nucl Med Mol Imaging 49, 1661–1670 (2022). https://doi.org/10.1007/s00259-021-05608-5

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