Use of Radioactive Iodine for Thyroid Cancer

Overview

Journal JAMA

Publisher American Medical Association

Specialty General Medicine

Date 2011 Aug 18

PMID 21846853

Citations 75

Authors

Megan R Haymart

Mousumi Banerjee

Andrew K Stewart

Ronald J Koenig

John D Birkmeyer

Jennifer J Griggs

Affiliations

Soon will be listed here.

Abstract

Context: Substantial uncertainty persists about the indications for radioactive iodine for thyroid cancer. Use of radioactive iodine over time and the correlates of its use remain unknown.

Objective: To determine practice patterns, the degree to which hospitals vary in their use of radioactive iodine, and factors that contribute to this variation.

Design, Setting, And Patients: Time trend analysis of radioactive iodine use in a cohort of 189,219 patients with well-differentiated thyroid cancer treated at 981 hospitals associated with the US National Cancer Database between 1990 and 2008. We used multilevel analysis to assess the correlates of patient and hospital characteristics on radioactive iodine use in the cohort treated from 2004 to 2008.

Main Outcome Measure: Use of radioactive iodine after total thyroidectomy.

Results: Between 1990 and 2008, across all tumor sizes, there was a significant increase in the proportion of patients with well-differentiated thyroid cancer receiving radioactive iodine (1373/3397 [40.4%] vs 11,539/20,620 [56.0%]; P < .001). Multivariable analysis of patients treated from 2004 to 2008 found that there was a statistical difference in radioactive iodine use between American Joint Committee on Cancer stages I and IV (odds ratio [OR], 0.34; 95% confidence interval [CI], 0.31-0.37) but not between stages II/III and IV (for stage II vs stage IV, OR, 0.97; 95% CI, 0.88-1.07 and for stage III vs stage IV, OR, 1.06; 95% CI, 0.95-1.17). In addition to patient and tumor characteristics, hospital volume was associated with radioactive iodine use. Wide variation in radioactive iodine use existed, and only 21.1% of this variation was accounted for by patient and tumor characteristics. Hospital type and case volume accounted for 17.1% of the variation. After adjusting for available patient, tumor, and hospital characteristics, 29.1% of the variance was attributable to unexplained hospital characteristics.

Conclusion: Among patients treated for well-differentiated thyroid cancer at hospitals in the National Cancer Database, there was an increase in the proportion receiving radioactive iodine between 1990 and 2008; much of the variation in use was associated with hospital characteristics.

Citing Articles

Physicians' preferencesfor radioiodine treatment of differentiated thyroid cancer in Brazil: an observational study.

Padovani R, Pansani I, Marone M, Vaisman F, Maia A, Dora J Arch Endocrinol Metab. 2024; 68:e230228.

PMID: 39420903 PMC: 11196101. DOI: 10.20945/2359-4292-2023-0228.

The effect of total thyroidectomy and radioactive iodine on long-term survival in unilateral T3/T4 follicular thyroid carcinoma: insights from a propensity-matched retrospective analysis.

Liu Y, Zhang M, Miao Y, Chen T, Meng T, Zhang T Gland Surg. 2024; 13(8):1477-1493.

PMID: 39282047 PMC: 11398996. DOI: 10.21037/gs-24-231.

Recent Advances in Metal-Organic Frameworks and Their Derivatives for Adsorption of Radioactive Iodine.

Peng L, Duan J, Liang Y, Zhang H, Duan C, Liu S Molecules. 2024; 29(17).

PMID: 39275018 PMC: 11397681. DOI: 10.3390/molecules29174170.

Racial-Ethnic Comparison of Treatment for Papillary Thyroid Cancer in the Military Health System.

Eaglehouse Y, Darmon S, Shriver C, Zhu K Ann Surg Oncol. 2024; 31(12):8196-8205.

PMID: 39085551 DOI: 10.1245/s10434-024-15941-2.

Survival benefit of postoperative radioiodine therapy among patients with intermediate-risk differentiated thyroid carcinoma.

Wang J, Mao Y, Li L, Liang J, Huang H, Lin W Endocrine. 2024; 86(2):664-671.

PMID: 38809346 DOI: 10.1007/s12020-024-03869-2.

References

Harach H, Franssila K, Wasenius V . Occult papillary carcinoma of the thyroid. A "normal" finding in Finland. A systematic autopsy study. Cancer. 1985; 56(3):531-8. DOI: 10.1002/1097-0142(19850801)56:3<531::aid-cncr2820560321>3.0.co;2-3. View

Birkmeyer J, Sharp S, Finlayson S, Fisher E, WENNBERG J . Variation profiles of common surgical procedures. Surgery. 1998; 124(5):917-23. View

Bonnet S, Hartl D, Leboulleux S, Baudin E, Lumbroso J, Al Ghuzlan A . Prophylactic lymph node dissection for papillary thyroid cancer less than 2 cm: implications for radioiodine treatment. J Clin Endocrinol Metab. 2009; 94(4):1162-7. DOI: 10.1210/jc.2008-1931. View

Tuttle R, Ball D, Byrd D, Dilawari R, Doherty G, Duh Q . Thyroid carcinoma. J Natl Compr Canc Netw. 2010; 8(11):1228-74. DOI: 10.6004/jnccn.2010.0093. View

Charlson M, Pompei P, Ales K, MacKenzie C . A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40(5):373-83. DOI: 10.1016/0021-9681(87)90171-8. View

Cobin R, Gharib H, Bergman D, Clark O, Cooper D, Daniels G . AACE/AAES medical/surgical guidelines for clinical practice: management of thyroid carcinoma. American Association of Clinical Endocrinologists. American College of Endocrinology. Endocr Pract. 2001; 7(3):202-20. View

Cooper D, Doherty G, Haugen B, Kloos R, Lee S, Mandel S . Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2006; 16(2):109-42. DOI: 10.1089/thy.2006.16.109. View

Ito Y, Masuoka H, Fukushima M, Inoue H, Kihara M, Tomoda C . Excellent prognosis of patients with solitary T1N0M0 papillary thyroid carcinoma who underwent thyroidectomy and elective lymph node dissection without radioiodine therapy. World J Surg. 2009; 34(6):1285-90. DOI: 10.1007/s00268-009-0356-0. View

Raval M, Bilimoria K, Stewart A, Bentrem D, Ko C . Using the NCDB for cancer care improvement: an introduction to available quality assessment tools. J Surg Oncol. 2009; 99(8):488-90. DOI: 10.1002/jso.21173. View

10.

Gilliland F, Hunt W, Morris D, Key C . Prognostic factors for thyroid carcinoma. A population-based study of 15,698 cases from the Surveillance, Epidemiology and End Results (SEER) program 1973-1991. Cancer. 1997; 79(3):564-73. DOI: 10.1002/(sici)1097-0142(19970201)79:3<564::aid-cncr20>3.0.co;2-0. View

11.

Sisson J, Freitas J, McDougall I, Dauer L, Hurley J, Brierley J . Radiation safety in the treatment of patients with thyroid diseases by radioiodine 131I : practice recommendations of the American Thyroid Association. Thyroid. 2011; 21(4):335-46. DOI: 10.1089/thy.2010.0403. View

12.

Bourgeois P . A proposition for the use of radioiodine in WDTC management. J Nucl Med. 2009; 50(2):328-9. DOI: 10.2967/jnumed.108.057141. View

13.

Malpani B, Samuel A, Ray S . Quantification of salivary gland function in thyroid cancer patients treated with radioiodine. Int J Radiat Oncol Biol Phys. 1996; 35(3):535-40. DOI: 10.1016/s0360-3016(96)80016-2. View

14.

Varma V, BEIERWALTES W, NOFAL M, NISHIYAMA R, Copp J . Treatment of thyroid cancer. Death rates after surgery and after surgery followed by sodium iodide I-131. JAMA. 1970; 214(8):1437-42. DOI: 10.1001/jama.214.8.1437. View

15.

Welch H, Black W . Overdiagnosis in cancer. J Natl Cancer Inst. 2010; 102(9):605-13. DOI: 10.1093/jnci/djq099. View

16.

Van Nostrand D, Neutze J, ATKINS F . Side effects of "rational dose" iodine-131 therapy for metastatic well-differentiated thyroid carcinoma. J Nucl Med. 1986; 27(10):1519-27. View

17.

Chen A, Jemal A, Ward E . Increasing incidence of differentiated thyroid cancer in the United States, 1988-2005. Cancer. 2009; 115(16):3801-7. DOI: 10.1002/cncr.24416. View

18.

Deyo R, Cherkin D, Ciol M . Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992; 45(6):613-9. DOI: 10.1016/0895-4356(92)90133-8. View

19.

Davies L, Welch H . Increasing incidence of thyroid cancer in the United States, 1973-2002. JAMA. 2006; 295(18):2164-7. DOI: 10.1001/jama.295.18.2164. View

20.

Molinaro E, Leboeuf R, Shue B, Martorella A, Fleisher M, Larson S . Mild decreases in white blood cell and platelet counts are present one year after radioactive iodine remnant ablation. Thyroid. 2009; 19(10):1035-41. DOI: 10.1089/thy.2008.0430. View