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

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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.

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Data availability

Raw data of this analysis are available from the corresponding author upon request.

Abbreviations

ATA:

American Thyroid Association

CI:

confidence interval

CT:

computed tomography

EBRT:

external-beam radiotherapy

ECE:

extra-capsular extension

HR:

hazard ratio

LRRFS:

locoregional recurrence-free survival

OS:

overall survival

PTC:

papillary thyroid carcinoma

RAI:

radioactive iodine

Tg:

thyroglobulin

TSH:

thyroid-stimulating hormone

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Authors and Affiliations

Authors

Contributions

T.K. prepared the manuscript and conducted the literature search; T.K. reviewed and edited the manuscript; and T.K., N.S., T.F., M.H., and T.Y. reviewed the manuscript. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Terufumi Kawamoto.

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The authors declare no competing interests.

Ethical approval

All procedures followed the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent to be included in the study was obtained from all patients. The study protocol was approved by the participating centers’ institutional review boards.

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Kawamoto, T., Shikama, N., Fukumori, T. et al. Long-term clinical outcomes and prognostic factors for patients with papillary thyroid carcinoma with other organ invasions after adjuvant radioactive iodine. Endocrine 80, 79–85 (2023). https://doi.org/10.1007/s12020-022-03251-0

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