ArticleAnnals of surgical oncology2025
The Impact of Radioactive Iodine on Disease-Specific Survival in Low-to-Intermediate Risk N1b Papillary Thyroid Carcinoma.
Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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Who cites it
3 citing papers in PubMed.
- ATA 2015-2025 risk stratification transition: prognostic significance of N1b disease in papillary thyroid carcinoma with limited nodal burden.The oncologist · 2026Article
- Investigation of depressive symptoms after thyroid cancer surgery: Logistic regression analysis and adjustment strategy.World journal of psychiatry · 2025Article
- Impact of positive lymph nodes and RAI therapy on survival in N1b papillary thyroid carcinoma.Frontiers in endocrinology · 2025Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe association of radioactive iodine (RAI) with disease-specific survival (DSS) is controversial in N1b papillary thyroid carcinoma (PTC). We aimed to evaluate whether RAI is associated with DSS in low-to-intermediate-risk N1b PTC.
methodsThe Surveillance, Epidemiology, and End Results database was queried for pT1-3, N1b, M0/Mx classic PTC treated with total thyroidectomy. Multivariable Cox regression was performed to identify predictors of DSS. Subanalyses were conducted for age, intermediate-risk versus otherwise low-risk features, and positive lymph node ratio (LNR) > 0.17.
resultsRadioactive iodine recipients were younger (43.0 vs. 44.0 years, p = 0.036) with increased capsular or local invasion (49.2% vs. 41.9%, p < 0.001) and median LNR (0.37 vs. 0.33, p = 0.001). Worse DSS was associated with age (adjusted-HR = 1.09, p < 0.001), tumor size (adjusted-HR = 1.02, p < 0.001), and local invasion (adjusted-HR = 1.86, p = 0.003). Radioactive iodine was associated with improved DSS in the whole cohort (adjusted-HR = 0.61, p = 0.014), in patients ≥ 55 years (adjusted-HR = 0.48, p = 0.001) and in patients ≥55 years with LNR > 0.17 (adjusted-HR = 0.45, p = 0.001) but not LNR ≤ 0.17. Radioactive iodine was not associated with a DSS benefit in patients < 55 years even when stratified by LNR 0.17. Radioactive iodine administered to patients with at least one intermediate-risk feature (> 5 pathologic LNs or any local invasion) was associated with improved DSS (adjusted-HR = 0.60, p = 0.019) but not those with otherwise low-risk features (adjusted-HR = 0.71, p = 0.502).
conclusionsRadioactive iodine is associated with improved DSS in N1b PTC patients with intermediate-risk features, age ≥ 55 years, and LNR > 0.17 in older patients, but not in patients with otherwise low-risk features. These factors could help guide RAI utilization in N1b PTC.
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