ArticleJournal of the Endocrine Society2026
Moderate- versus high-activity radioactive iodine in intermediate-risk papillary thyroid cancer: a Canadian cohort study.
Article in Journal of the Endocrine Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Moderate- versus high-activity radioactive iodine in intermediate-risk papillary thyroid cancer: a Canadian cohort study.Journal of the Endocrine Society · 2026Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Context: The optimal radioactive iodine (RAI) activity for intermediate-risk papillary thyroid cancer (PTC) remains uncertain, and evidence to guide individualized treatment is limited. Objective: To compare recurrence between moderate- and high-activity RAI and to identify clinicopathologic factors associated with persistent or recurrent disease. Methods: We conducted a retrospective cohort study of adults with intermediate-risk PTC treated at a tertiary academic thyroid cancer clinic between 2010 and 2022. Patients received moderate-activity RAI, defined as 30 to 90 mCi, or high-activity RAI, defined as greater than 90 mCi, as initial postoperative therapy. The primary outcome was time to recurrence. The secondary outcome was a composite of persistent or recurrent disease at last follow-up. Results: Among 181 patients, 94 received moderate-activity RAI and 87 received high-activity RAI. Over a median follow-up of 52 months, 18 recurrences occurred (crude: 3/94 vs 15/87). High-activity RAI was not associated with improved recurrence-free survival (inverse probability of treatment weighting [IPTW]-weighted hazard ratio 2.73; 95% confidence interval [CI] 0.74 to 10.01). Persistent or recurrent disease occurred in 61 patients (34%) with no association in IPTW models (hazard ratio 0.97; 95% CI 0.53 to 1.76). Extranodal extension, microscopic extrathyroidal extension, larger lymph node deposit size, and older age were associated with persistent or recurrent disease. Conclusion: High-activity RAI was not associated with improved recurrence versus moderate-activity in intermediate-risk PTC. This study is among the first to evaluate moderate-activity RAI as a distinct comparator. Findings support moderate-activity RAI as a reasonable risk-adapted approach. Prospective studies are needed to validate these results.
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