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Erschienen in:
18.05.2016 | Original Article
Implication of different clinical and pathological variables in patients with differentiated thyroid cancer on successful ablation for 3700 MBq 131I: a single Egyptian institutional experience over 14 years
Erschienen in: Annals of Nuclear Medicine | Ausgabe 7/2016
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Objective
Is to investigate possible factors predicting success of ablation for 3700 MBq radioactive iodine 131 in patients with differentiated thyroid cancer (DTC) following near total thyroidectomy.
Methods
This retrospective study enrolled 272 patients between 2000 and 2014. The success or failure of ablation was assessed 6 months after given the dose and our criteria for complete successful remnant ablation defined as: Negative 131I whole body scan with no residual functioning thyroid tissue or distant functioning metastases and stimulated thyroglobulin (Tg) level less than 2 ng/ml. Different clinical and pathological factors, such as age, gender, tumor histology, grade and variants, size of primary malignant lesion, stage, and risk assessment according to the American (ATA) and European Thyroid Association (ETA) guidelines, associated pathology, tumor mutifocality, lymph node (LN) metastases and their number, invasiveness of the tumor (capsular invasion of the nodule, extra-thyroidal extension, and vascular invasion), baseline stimulated Tg level, and pre-ablative diagnostic scan were assessed.
Results
There were 185 successful ablations (68 %). The baseline-stimulated Tg measured before the ablation was the only independent predictor of ablation success in multivariate analysis (P < 0.0001) with odds ratio (OR) of 2.64 (95 % CI: 1.54–4.54) and the optimal cutoff for this was 3.8 ng/mL. On the univariate analysis, LN metastases was predictor of ablation failure (P value = 0.03).
Conclusion
Baseline-stimulated Tg level is clinically important and had a significant predictive value for successful ablation; therefore, higher pre-ablation Tg should potentially be incorporated in the decision making for 131I dosage or other treatment. In accordance with other studies, this is also applicable to cervical lymph nodal involvement and thyroid capsule invasion.