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Lack of Efficacy of Radioiodine Remnant Ablation for Papillary Thyroid Microcarcinoma: Verification Using Inverse Probability of Treatment Weighting

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

Abstract

Background

Most of the increase in thyroid cancer in recent decades has been due to papillary thyroid microcarcinoma (PTMC). We evaluated the efficacy of radioiodine remnant ablation (RRA) in patients with PTMC.

Methods

This historical cohort study included 1932 PTMC patients without lateral cervical lymph node (LN) or distant metastasis who underwent total thyroidectomy (TT) during the median 8.3 years of follow-up. The clinical outcomes of patients with or without RRA were compared using weighted logistic regression models with the inverse probability of treatment weighting (IPTW) method and considering risk factors, including age, sex, primary tumor size, extrathyroidal extension, multifocality, and central cervical LN metastasis.

Results

The median primary tumor size of the RRA group was significantly larger than that of the no-RRA group (0.7 vs. 0.5 cm, P < 0.001). There were significantly more patients with multifocality, extrathyroidal extension, and cervical LN metastasis in the RRA group compared with the no-RRA group. There was no significant difference in recurrence-free survival between the two groups (P = 0.11). Cox proportional–hazard analysis with IPTW by adjusting for clinicopathological risk factors demonstrated no significant difference in recurrence of PTMC according to RRA treatment (hazard ratio [HR] 2.02; 95% confidence interval [CI] 0.65–6.25; P = 0.2).

Conclusions

RRA had no therapeutic effect on the clinical outcomes of patients with PTMC who underwent TT. Surgical treatment without RRA could be applicable for patients with PTMC if there is no evidence of lateral cervical LN metastasis or distant metastasis.

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Acknowledgment

The Journal acknowledges that author retains the right to provide an electronic copy of the final peer-reviewed manuscript to Korea PubMed Central (PMC) upon acceptance for publication and make it publicly available as soon as possible but no later than 12 months after publication.

Disclosure

The authors declare that they have no conflict of interest.

Funding

This study was supported by a Grant of the Korean Health Technology R&D project, Ministry of Health & Welfare, Republic of Korea (HC15C3372) and a Grant (No. 2015-289) of Asan Institute for Life Sciences, Seoul, Korea.

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Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Hyemi Kwon MD, Min Ji Jeon MD, PhD, Won Gu Kim MD, PhD, Suyeon Park MD, Mijin Kim MD, Tae Yong Kim MD, PhD, Young Kee Shong MD, PhD & Won Bae Kim MD, PhD

  2. Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

    Hyemi Kwon MD

  3. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Minkyu Han PhD

  4. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Dong Eun Song MD, PhD

  5. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Tae-Yon Sung MD, PhD, Jong Ho Yoon MD, PhD & Suck Joon Hong MD, PhD

  6. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Jin-Sook Ryu MD, PhD

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  1. Hyemi Kwon MD
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  2. Min Ji Jeon MD, PhD
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  3. Won Gu Kim MD, PhD
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Correspondence to Won Bae Kim MD, PhD.

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Kwon, H., Jeon, M.J., Kim, W.G. et al. Lack of Efficacy of Radioiodine Remnant Ablation for Papillary Thyroid Microcarcinoma: Verification Using Inverse Probability of Treatment Weighting. Ann Surg Oncol 24, 2596–2602 (2017). https://doi.org/10.1245/s10434-017-5910-7

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  • DOI: https://doi.org/10.1245/s10434-017-5910-7

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