Nazish Fatima, Zareen Kiran, Javaid Iqbal, Akhtar Ali Baloch, S M Salman Habib, Akhtar Ahmed
{"title":"甲状腺切除术后未经放射性碘 (RAI) 消融治疗的低风险分化型甲状腺癌 (DTC) 的疗效：卡拉奇一家三级医疗中心的经验。","authors":"Nazish Fatima, Zareen Kiran, Javaid Iqbal, Akhtar Ali Baloch, S M Salman Habib, Akhtar Ahmed","doi":"10.29271/jcpsp.2024.08.968","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To assess the outcomes of low-risk differentiated thyroid cancer (DTC) with tumour size 1 to 4 cm post-thyroidectomy in patients who never received radioactive iodine (RAI) ablation and to compare the outcomes with those who received RAI therapy.</p><p><strong>Study design: </strong>Observational study. Place and Duration of the Study: Department of Nuclear Medicine, Karachi Institute of Radiotherapy and Nuclear Medicine (KIRAN) Hospital, Karachi, Pakistan, from January 2016 to December 2020.</p><p><strong>Methodology: </strong>A total of 130 consecutive patients of low-risk DTC of both genders aged between 18-75 years were identified who underwent thyroidectomy. Patients were classified as either being treated or not treated with RAI, based on RAI data post-thyroidectomy. Patients were followed up for two to five years depending on their date of diagnosis from 2016 to 2020, using thyroglobulin (Tg), anti-thyroglobulin (anti-Tg), and thyrotropin (TSH) levels and ultrasound neck. Association between patients who received RAI and who did not receive RAI was determined and a p-value <0.05 was considered as statistical significance.</p><p><strong>Results: </strong>Patients had mean age of 34.5 ± 10.4 years with majority of females (75.4%). Majority of the patients (94.6%) had total thyroidectomy with no neck dissection (83.1%). RAI therapy was conducted among 70.8% participants, of which, 56.9% participants received a dose of 100 mci. Most of the patients had positive outcomes as there was no recurrence among 96.2% participants. There was a significant difference in RAI therapy with total thyroidectomy as compared to subtotal, RAI dose, tumour stage, neck dissection, and lymph node involvement (p ≤0.001).</p><p><strong>Conclusion: </strong>After complete tumour resection, a highly selected group of patients with low-risk local disease have shown low rate of recurrence when managed without RAI. Interestingly, the disease recurrence was also only seen in patients who received RAI therapy in comparison to those who did not receive RAI therapy.</p><p><strong>Key words: </strong>Outcomes, Differentiated thyroid cancer, Radioactive iodine, Ablation therapy, Post-surgery.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 8","pages":"968-973"},"PeriodicalIF":0.0000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Outcomes of Low-Risk Differentiated Thyroid Cancer (DTC) without Radioactive Iodine (RAI) Ablation Therapy Post-Thyroidectomy: An Experience from a Tertiary Centre in Karachi.\",\"authors\":\"Nazish Fatima, Zareen Kiran, Javaid Iqbal, Akhtar Ali Baloch, S M Salman Habib, Akhtar Ahmed\",\"doi\":\"10.29271/jcpsp.2024.08.968\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To assess the outcomes of low-risk differentiated thyroid cancer (DTC) with tumour size 1 to 4 cm post-thyroidectomy in patients who never received radioactive iodine (RAI) ablation and to compare the outcomes with those who received RAI therapy.</p><p><strong>Study design: </strong>Observational study. Place and Duration of the Study: Department of Nuclear Medicine, Karachi Institute of Radiotherapy and Nuclear Medicine (KIRAN) Hospital, Karachi, Pakistan, from January 2016 to December 2020.</p><p><strong>Methodology: </strong>A total of 130 consecutive patients of low-risk DTC of both genders aged between 18-75 years were identified who underwent thyroidectomy. Patients were classified as either being treated or not treated with RAI, based on RAI data post-thyroidectomy. Patients were followed up for two to five years depending on their date of diagnosis from 2016 to 2020, using thyroglobulin (Tg), anti-thyroglobulin (anti-Tg), and thyrotropin (TSH) levels and ultrasound neck. Association between patients who received RAI and who did not receive RAI was determined and a p-value <0.05 was considered as statistical significance.</p><p><strong>Results: </strong>Patients had mean age of 34.5 ± 10.4 years with majority of females (75.4%). Majority of the patients (94.6%) had total thyroidectomy with no neck dissection (83.1%). RAI therapy was conducted among 70.8% participants, of which, 56.9% participants received a dose of 100 mci. Most of the patients had positive outcomes as there was no recurrence among 96.2% participants. There was a significant difference in RAI therapy with total thyroidectomy as compared to subtotal, RAI dose, tumour stage, neck dissection, and lymph node involvement (p ≤0.001).</p><p><strong>Conclusion: </strong>After complete tumour resection, a highly selected group of patients with low-risk local disease have shown low rate of recurrence when managed without RAI. 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引用次数: 0
摘要
目的评估甲状腺切除术后肿瘤大小为1至4厘米的低危分化型甲状腺癌（DTC）患者中从未接受过放射性碘（RAI）消融治疗者的预后，并与接受过RAI治疗者的预后进行比较：观察性研究。研究地点和时间：巴基斯坦卡拉奇放疗与核医学研究所（KIRAN）医院核医学科，2016年1月至2020年12月：共确定了 130 名接受甲状腺切除术的低风险 DTC 连续患者，男女患者年龄均在 18-75 岁之间。根据甲状腺切除术后的 RAI 数据，将患者分为接受 RAI 治疗和未接受 RAI 治疗两类。从2016年到2020年，根据患者的诊断日期，采用甲状腺球蛋白（Tg）、抗甲状腺球蛋白（anti-Tg）、促甲状腺激素（TSH）水平和颈部超声波对患者进行了2到5年的随访。确定接受 RAI 和未接受 RAI 的患者之间的关联，并得出 p 值 结果：患者平均年龄为（34.5 ± 10.4）岁，女性占多数（75.4%）。大多数患者（94.6%）接受了全甲状腺切除术，其中 83.1%未进行颈部切除。70.8%的患者接受了 RAI 治疗，其中 56.9% 的患者接受了 100 mci 的剂量。大多数患者的治疗效果良好，96.2%的患者没有复发。甲状腺全切除术与次全切除术的 RAI 治疗、RAI 剂量、肿瘤分期、颈部切除术和淋巴结受累情况相比均有显著差异（P ≤0.001）：完全切除肿瘤后，经过严格筛选的低风险局部疾病患者在不使用 RAI 的情况下复发率较低。有趣的是，与未接受 RAI 治疗的患者相比，只有接受 RAI 治疗的患者才会出现疾病复发：结果 分化性甲状腺癌 放射性碘 消融治疗 手术后
Outcomes of Low-Risk Differentiated Thyroid Cancer (DTC) without Radioactive Iodine (RAI) Ablation Therapy Post-Thyroidectomy: An Experience from a Tertiary Centre in Karachi.
Objective: To assess the outcomes of low-risk differentiated thyroid cancer (DTC) with tumour size 1 to 4 cm post-thyroidectomy in patients who never received radioactive iodine (RAI) ablation and to compare the outcomes with those who received RAI therapy.
Study design: Observational study. Place and Duration of the Study: Department of Nuclear Medicine, Karachi Institute of Radiotherapy and Nuclear Medicine (KIRAN) Hospital, Karachi, Pakistan, from January 2016 to December 2020.
Methodology: A total of 130 consecutive patients of low-risk DTC of both genders aged between 18-75 years were identified who underwent thyroidectomy. Patients were classified as either being treated or not treated with RAI, based on RAI data post-thyroidectomy. Patients were followed up for two to five years depending on their date of diagnosis from 2016 to 2020, using thyroglobulin (Tg), anti-thyroglobulin (anti-Tg), and thyrotropin (TSH) levels and ultrasound neck. Association between patients who received RAI and who did not receive RAI was determined and a p-value <0.05 was considered as statistical significance.
Results: Patients had mean age of 34.5 ± 10.4 years with majority of females (75.4%). Majority of the patients (94.6%) had total thyroidectomy with no neck dissection (83.1%). RAI therapy was conducted among 70.8% participants, of which, 56.9% participants received a dose of 100 mci. Most of the patients had positive outcomes as there was no recurrence among 96.2% participants. There was a significant difference in RAI therapy with total thyroidectomy as compared to subtotal, RAI dose, tumour stage, neck dissection, and lymph node involvement (p ≤0.001).
Conclusion: After complete tumour resection, a highly selected group of patients with low-risk local disease have shown low rate of recurrence when managed without RAI. Interestingly, the disease recurrence was also only seen in patients who received RAI therapy in comparison to those who did not receive RAI therapy.
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