BACKGROUND

The beneficial effects of radioactive iodine (RAI) ablation for intermediate-risk papillary thyroid cancer (PTC) patients are still controversial.

MATERIALS AND METHODS

To determine the impact of RAI therapy on disease-specific survival (DSS) in patients with intermediate-risk PTC, we retrospectively analyzed the data of 23107 intermediate-risk PTC patients who underwent primary thyroidectomy with or without RAI in the Surveillance, Epidemiology, and End Results (SEER) database.

RESULTS

RAI therapy was significantly associated with improved DSS (adjusted HR = 0.65, P = 0.017) in intermediate-risk PTC patients after multivariate adjusting for clinicopathological characteristics. However, subgroup analyses demonstrated that RAI ablation was only associated with improved DSS in patients with male gender (adjusted HR = 0.47, P = 0.005), age ≥ 45 years (adjusted HR = 0.34, P < 0.001) and tumor size > 20 mm (adjusted HR = 0.58, P = 0.007).

CONCLUSION

RAI decision-making should be considered on an individual basis rather than "one size fits all" in intermediate-risk PTC patients; only patients with male gender, age ≥ 45 years, and tumor size > 20 mm may benefit from RAI therapy.