National Institute of Diabetes and Endocrinology, Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan.
Department of Nuclear Medicine, Karachi Institute of Radiotherapy and Nuclear Medicine (KIRAN) Hospital, Karachi, Pakistan.
J Coll Physicians Surg Pak. 2024 Aug;34(8):968-973. doi: 10.29271/jcpsp.2024.08.968.
To assess the outcomes of low-risk differentiated thyroid cancer (DTC) with tumour size 1 to 4 cm post-thyroidectomy in patients who never received radioactive iodine (RAI) ablation and to compare the outcomes with those who received RAI therapy.
Observational study. Place and Duration of the Study: Department of Nuclear Medicine, Karachi Institute of Radiotherapy and Nuclear Medicine (KIRAN) Hospital, Karachi, Pakistan, from January 2016 to December 2020.
A total of 130 consecutive patients of low-risk DTC of both genders aged between 18-75 years were identified who underwent thyroidectomy. Patients were classified as either being treated or not treated with RAI, based on RAI data post-thyroidectomy. Patients were followed up for two to five years depending on their date of diagnosis from 2016 to 2020, using thyroglobulin (Tg), anti-thyroglobulin (anti-Tg), and thyrotropin (TSH) levels and ultrasound neck. Association between patients who received RAI and who did not receive RAI was determined and a p-value <0.05 was considered as statistical significance.
Patients had mean age of 34.5 ± 10.4 years with majority of females (75.4%). Majority of the patients (94.6%) had total thyroidectomy with no neck dissection (83.1%). RAI therapy was conducted among 70.8% participants, of which, 56.9% participants received a dose of 100 mci. Most of the patients had positive outcomes as there was no recurrence among 96.2% participants. There was a significant difference in RAI therapy with total thyroidectomy as compared to subtotal, RAI dose, tumour stage, neck dissection, and lymph node involvement (p ≤0.001).
After complete tumour resection, a highly selected group of patients with low-risk local disease have shown low rate of recurrence when managed without RAI. Interestingly, the disease recurrence was also only seen in patients who received RAI therapy in comparison to those who did not receive RAI therapy.
Outcomes, Differentiated thyroid cancer, Radioactive iodine, Ablation therapy, Post-surgery.
评估甲状腺切除术后从未接受放射性碘（RAI）消融治疗且肿瘤大小为 1 至 4 厘米的低危分化型甲状腺癌（DTC）患者的治疗结果，并与接受 RAI 治疗的患者进行比较。
观察性研究。研究地点和时间：巴基斯坦卡拉奇放射治疗与核医学研究所（KIRAN）医院核医学科，2016 年 1 月至 2020 年 12 月。
共纳入 130 例 18-75 岁的低危 DTC 患者，男女不限，均接受甲状腺切除术。根据甲状腺切除术后的 RAI 数据，将患者分为接受或未接受 RAI 治疗。患者从 2016 年至 2020 年进行为期 2 至 5 年的随访，通过检测甲状腺球蛋白（Tg）、抗甲状腺球蛋白（anti-Tg）和促甲状腺激素（TSH）水平以及颈部超声来监测疾病情况。确定接受 RAI 治疗和未接受 RAI 治疗的患者之间的关系，p 值＜0.05 被认为具有统计学意义。
患者的平均年龄为 34.5 ± 10.4 岁，其中女性（75.4%）居多。大多数患者（94.6%）行甲状腺全切除术，无颈部淋巴结清扫术（83.1%）。70.8%的患者接受了 RAI 治疗，其中 56.9%的患者接受了 100 mci 的剂量。大多数患者的治疗效果良好，96.2%的患者无复发。RAI 治疗与甲状腺全切除术、RAI 剂量、肿瘤分期、颈部淋巴结清扫术和淋巴结受累情况之间存在显著差异（p ≤0.001）。
在完全切除肿瘤后，一组高度选择的低危局部疾病患者在不接受 RAI 治疗的情况下，复发率较低。有趣的是，与未接受 RAI 治疗的患者相比，仅在接受 RAI 治疗的患者中观察到疾病复发。
结果、分化型甲状腺癌、放射性碘、消融治疗、术后。
