Ablation rate after radioactive iodine therapy in patients with differentiated thyroid cancer at intermediate or high risk of recurrence: a systematic review and a meta-analysis.

Abstract

PURPOSE:

We performed a systematic review and a meta-analysis to investigate the successful ablation rate after radioiodine (RAI) administration in patients with differentiated thyroid cancer (DTC) at intermediate-high risk of recurrence.

METHODS:

A comprehensive literature search of the PubMed, Scopus, and Web of Science databases was conducted according to the PRISMA statement.

RESULTS:

The final analysis included 9 studies accounting for 3103 patients at intermediate-high risk of recurrence. In these patients, the successful ablation rates ranged from 51 to 94% with a 71% pooled successful ablation and were higher in intermediate (72%) than in high (52%)-risk patients. Despite the rigorous inclusion standards, a significant heterogeneity among the evaluated studies was observed. Higher administered RAI activities are associated with a lower successful ablation rate in the whole population and in the subgroup of high-risk patients. Furthermore, pooled recurrence rate in intermediate-risk patients achieving successful ablation was only 2% during the subsequent 6.4-year follow-up while the pooled recurrence rate was 14% in patients who did not achieve a successful ablation.

CONCLUSION:

In a large sample of 3103 patients at intermediate-high risk of persistent/recurrent disease, 71% of patients achieved a successful ablation. In these intermediate-risk patients, the probability of subsequent recurrence is low and most recurrence occurred in those with already abnormal findings at the first control.

• Authors: Michele Klain, Carmela Nappi, Emilia Zampella, Valeria Cantoni, Roberta Green, Leandra Piscopo, Fabio Volpe, Mariarosaria Manganelli, Elisa Caiazzo, Mario Petretta, Martin Schlumberger, Alberto Cuocolo
• Journal: European journal of nuclear medicine and molecular imaging (Eur J Nucl Med Mol Imaging) Vol. 48 Issue 13 Pg. 4437-4444 (12 2021) ISSN: 1619-7089 [Electronic] Germany
• PMID: 34142215 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)
• Copyright: © 2021. The Author(s).

Chemical References

• Iodine Radioisotopes

Topics

• Adenocarcinoma
• Humans
• Iodine Radioisotopes (therapeutic use)
• Neoplasm Recurrence, Local
• Retrospective Studies
• Thyroid Neoplasms (radiotherapy, surgery)
• Thyroidectomy