Impact of extent thyroidectomy and radioactive iodine ablation for disease free survival in the intermediate-risk patients with lateral neck lymph node metastasis: a retrospective and tentative real-world approach
Abstract Background It is controversial whether or not total thyroidectomy followed by radioactive iodine ablation (RAI-a) (30 mCi = 1.1 GBq) is mandatory in intermediate-risk patients with lateral neck lymph node metastasis (cN1b). Methods This retrospective observational study enrolled PTC patient...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-07-01
|
| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-025-03912-0 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849768987964997632 |
|---|---|
| author | Kiyomi Horiuchi Yuki Yamanashi Tomoyoshi Nakai Juro Yanagida Yusaku Yoshida Yoko Omi Takahiro Okamoto |
| author_facet | Kiyomi Horiuchi Yuki Yamanashi Tomoyoshi Nakai Juro Yanagida Yusaku Yoshida Yoko Omi Takahiro Okamoto |
| author_sort | Kiyomi Horiuchi |
| collection | DOAJ |
| description | Abstract Background It is controversial whether or not total thyroidectomy followed by radioactive iodine ablation (RAI-a) (30 mCi = 1.1 GBq) is mandatory in intermediate-risk patients with lateral neck lymph node metastasis (cN1b). Methods This retrospective observational study enrolled PTC patients classified preoperatively as the intermediate-risk with cN1b from January 2010 to December 2017 according to the guidelines for thyroid tumors of the Japanese Association of Endocrine Surgeons (JAES) since 2009. We analyzed recurrence-free survival (RFS) rates estimated by the Kaplan–Meier method in the patients classified into three groups: 1) total thyroidectomy (TTx) followed by lateral neck lymph node dissection (LLND) with RAI-a, 2) TTx + LLND without RAI-a, 3) hemithyroidectomy + LLND. In addition, propensity score analysis adjusted by clinical parameters was performed. Results Two hundred eighty-eight patients with intermediate-risk PTC were identified. Among them, 87 patients with cN1b were analyzed. Five-year RFS rates in 1), 2), and 3) groups were 85.0%, 100%, and 90.9%, respectively. The analysis of 1) and 2) groups by propensity score matching revealed 5-yr RFS rates of 84.1% and 100%, respectively (p < 0.0432). Conclusions There was no evidence to support the use of 30 mCi (1.1GBq) radioactive iodine postoperatively to prevent recurrence in intermediate-risk PTC patients with cN1b. |
| format | Article |
| id | doaj-art-d88061cda50244f9bbebd95bea21e10b |
| institution | DOAJ |
| issn | 1477-7819 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj-art-d88061cda50244f9bbebd95bea21e10b2025-08-20T03:03:37ZengBMCWorld Journal of Surgical Oncology1477-78192025-07-012311810.1186/s12957-025-03912-0Impact of extent thyroidectomy and radioactive iodine ablation for disease free survival in the intermediate-risk patients with lateral neck lymph node metastasis: a retrospective and tentative real-world approachKiyomi Horiuchi0Yuki Yamanashi1Tomoyoshi Nakai2Juro Yanagida3Yusaku Yoshida4Yoko Omi5Takahiro Okamoto6Department of Endocrine Surgery, Tokyo Women’s Medical UniversityDepartment of Endocrine Surgery, Tokyo Women’s Medical UniversityDepartment of Endocrine Surgery, Tokyo Women’s Medical UniversityDepartment of Endocrine Surgery, Tokyo Women’s Medical UniversityDepartment of Endocrine Surgery, Tokyo Women’s Medical UniversityDepartment of Endocrine Surgery, Tokyo Women’s Medical UniversityDepartment of Endocrine Surgery, Tokyo Women’s Medical UniversityAbstract Background It is controversial whether or not total thyroidectomy followed by radioactive iodine ablation (RAI-a) (30 mCi = 1.1 GBq) is mandatory in intermediate-risk patients with lateral neck lymph node metastasis (cN1b). Methods This retrospective observational study enrolled PTC patients classified preoperatively as the intermediate-risk with cN1b from January 2010 to December 2017 according to the guidelines for thyroid tumors of the Japanese Association of Endocrine Surgeons (JAES) since 2009. We analyzed recurrence-free survival (RFS) rates estimated by the Kaplan–Meier method in the patients classified into three groups: 1) total thyroidectomy (TTx) followed by lateral neck lymph node dissection (LLND) with RAI-a, 2) TTx + LLND without RAI-a, 3) hemithyroidectomy + LLND. In addition, propensity score analysis adjusted by clinical parameters was performed. Results Two hundred eighty-eight patients with intermediate-risk PTC were identified. Among them, 87 patients with cN1b were analyzed. Five-year RFS rates in 1), 2), and 3) groups were 85.0%, 100%, and 90.9%, respectively. The analysis of 1) and 2) groups by propensity score matching revealed 5-yr RFS rates of 84.1% and 100%, respectively (p < 0.0432). Conclusions There was no evidence to support the use of 30 mCi (1.1GBq) radioactive iodine postoperatively to prevent recurrence in intermediate-risk PTC patients with cN1b.https://doi.org/10.1186/s12957-025-03912-0Papillary thyroid cancerIntermediate riskRadioactive iodine ablationThyroidectomy |
| spellingShingle | Kiyomi Horiuchi Yuki Yamanashi Tomoyoshi Nakai Juro Yanagida Yusaku Yoshida Yoko Omi Takahiro Okamoto Impact of extent thyroidectomy and radioactive iodine ablation for disease free survival in the intermediate-risk patients with lateral neck lymph node metastasis: a retrospective and tentative real-world approach World Journal of Surgical Oncology Papillary thyroid cancer Intermediate risk Radioactive iodine ablation Thyroidectomy |
| title | Impact of extent thyroidectomy and radioactive iodine ablation for disease free survival in the intermediate-risk patients with lateral neck lymph node metastasis: a retrospective and tentative real-world approach |
| title_full | Impact of extent thyroidectomy and radioactive iodine ablation for disease free survival in the intermediate-risk patients with lateral neck lymph node metastasis: a retrospective and tentative real-world approach |
| title_fullStr | Impact of extent thyroidectomy and radioactive iodine ablation for disease free survival in the intermediate-risk patients with lateral neck lymph node metastasis: a retrospective and tentative real-world approach |
| title_full_unstemmed | Impact of extent thyroidectomy and radioactive iodine ablation for disease free survival in the intermediate-risk patients with lateral neck lymph node metastasis: a retrospective and tentative real-world approach |
| title_short | Impact of extent thyroidectomy and radioactive iodine ablation for disease free survival in the intermediate-risk patients with lateral neck lymph node metastasis: a retrospective and tentative real-world approach |
| title_sort | impact of extent thyroidectomy and radioactive iodine ablation for disease free survival in the intermediate risk patients with lateral neck lymph node metastasis a retrospective and tentative real world approach |
| topic | Papillary thyroid cancer Intermediate risk Radioactive iodine ablation Thyroidectomy |
| url | https://doi.org/10.1186/s12957-025-03912-0 |
| work_keys_str_mv | AT kiyomihoriuchi impactofextentthyroidectomyandradioactiveiodineablationfordiseasefreesurvivalintheintermediateriskpatientswithlateralnecklymphnodemetastasisaretrospectiveandtentativerealworldapproach AT yukiyamanashi impactofextentthyroidectomyandradioactiveiodineablationfordiseasefreesurvivalintheintermediateriskpatientswithlateralnecklymphnodemetastasisaretrospectiveandtentativerealworldapproach AT tomoyoshinakai impactofextentthyroidectomyandradioactiveiodineablationfordiseasefreesurvivalintheintermediateriskpatientswithlateralnecklymphnodemetastasisaretrospectiveandtentativerealworldapproach AT juroyanagida impactofextentthyroidectomyandradioactiveiodineablationfordiseasefreesurvivalintheintermediateriskpatientswithlateralnecklymphnodemetastasisaretrospectiveandtentativerealworldapproach AT yusakuyoshida impactofextentthyroidectomyandradioactiveiodineablationfordiseasefreesurvivalintheintermediateriskpatientswithlateralnecklymphnodemetastasisaretrospectiveandtentativerealworldapproach AT yokoomi impactofextentthyroidectomyandradioactiveiodineablationfordiseasefreesurvivalintheintermediateriskpatientswithlateralnecklymphnodemetastasisaretrospectiveandtentativerealworldapproach AT takahirookamoto impactofextentthyroidectomyandradioactiveiodineablationfordiseasefreesurvivalintheintermediateriskpatientswithlateralnecklymphnodemetastasisaretrospectiveandtentativerealworldapproach |