Analysis of tumor recurrence factors of the patients with intermediate risk papillary thyroid carcinoma after radioactive iodine treatment

doi:10.16139/j.1007-9610.2023.06.09

Abstract

Abstract:

Objective To analyze the recurrence factors of the patients with intermediate risk papillary thyroid carcinoma (PTC) after radioactive iodine treatment (RAIT). Methods A total of 254 intermediate risk PTC patients after RAIT from January 2018 to May 2020 in our hospital were enrolled into this study. Chi square test and multivariate analysis were applied to analyze the main recurrence factors after RAIT. Results Thirty four (13.4%) patients with intermediate risk PTC relapsed after RAIT. The primary tumor size, lymph node metastasis staging, and pre-ablation stimulated thyroglobulin (psTg) were associated with tumor recurrence. According to the receiver operating characteristic （ROC） curve, psTg 25.6 μg/L was the best cutoff value for predicting recurrence. Further multivariate analysis revealed that lymph node metastasis staging and psTg levels were independent factors of predicting PTC recurrence. When the patients with N1b and psTg≥25.6 μg/L, the incidence of tumor recurrence after RAIT was 58.3%. While the patients with N1a and psTg<25.6 μg/L, the incidengce of tumor recurrence was only 2.3%. Conclusions Lymph node metastasis staging and psTg level are the important indicators of PTC recurrence, and combining these two indicators can help predict tumor recurrence after RAIT.

Key words: Papillary thyroid carcinoma, Intermediate risk, Radioactive iodine treatment, Tumor recurrence, Thyroglobulin

CLC Number:

R736.1

TANG Linglin, LI Li, LAI Yi, LIU Jianjun, ZHOU Xiang. Analysis of tumor recurrence factors of the patients with intermediate risk papillary thyroid carcinoma after radioactive iodine treatment[J]. Journal of Surgery Concepts & Practice, 2023, 28(06): 536-539.

Figures/Tables 3

References 14

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Characteristics	n	Excellent response	Recurrent disease	χ² value	P value
Number of patients	254	220	34
Gender
Male	108	89	19	2.87	0.09
Female	146	131	15
Age
≥55 year	58	53	5	1.47	0.23
<55 year	196	167	29
Residual thyroid
≤1 g	212	186	26	1.39	0.24
>1 g	42	34	8
Primary tumor size（long diameter）
≥4 cm	37	28	9	4.47	0.04
<4 cm	217	192	25
Number of primary tumor
1	87	74	13	0.28	0.60
>1	167	146	21
Lymph node metastasis
N1a	86	80	6	4.61	0.03
N1b	168	140	28
BRAF mutation^a)
-	93	79	14	0.96	0.33
+	82	65	17

Parameters	OR	95%CI	P value
psTg	24.8	9.7-63.5	<0.01
N staging	6.8	2.2-20.9	<0.01

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