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- Title
Factors influencing radioiodine uptake after thyroid cancer surgery.
- Authors
Bai, Jia Bin; Shakerian, Rezvaneh; Westcott, James David; Lichtenstein, Meir; Miller, Julie A.
- Abstract
Background Total thyroidectomy followed by radioactive iodine ( RAI) ablation is indicated for most patients with differentiated thyroid cancer. There have been no quantitative studies testing factors that affect uptake on post-ablation whole body scan. We hypothesized greater RAI uptake in patients who underwent two-stage total thyroidectomy (diagnostic hemithyroidectomy followed by completion thyroidectomy) compared to patients who underwent one-stage total thyroidectomy. Methods Medical records and whole body scan images of thyroid cancer patients were reviewed. Thyroid uptake as a percentage of Iodine-131 dose was calculated for each scan. RAI uptake was compared to procedure type, central lymph node dissection ( CLND), extrathyroidal invasion, presence of thyroiditis and pre-operative diagnosis. Results One hundred six patients who underwent total thyroidectomy and RAI ablation for differentiated thyroid cancer were included. There was a trend to higher RAI uptake in patients who had undergone two-stage thyroidectomy compared to one-stage thyroidectomy ( P = 0.06). CLND was associated significantly lower RAI uptake ( P = 0.003). On multivariate analyses, CLND was the only variable that retained statistical significance ( P = 0.023). CLND was performed more often in patients undergoing one-stage thyroidectomy ( P = 0.001), as these patients' cancer diagnosis was known prior to surgery. Conclusion RAI uptake appeared higher in two-stage thyroidectomy than one-stage thyroidectomy. This difference may be attributed to CLND being performed more often in one-stage thyroidectomy. These results add to the discussion about the role of CLND in surgery for differentiated thyroid cancer.
- Subjects
THERAPEUTIC use of iodine isotopes; ABLATION techniques; THYROID cancer treatment; THYROIDECTOMY; LYMPH node surgery
- Publication
ANZ Journal of Surgery, 2015, Vol 85, Issue 7/8, p572
- ISSN
1445-1433
- Publication type
Article
- DOI
10.1111/ans.12368