The impact of radioactive iodine treatment on survival among papillary thyroid cancer patients according to the 7th and
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ORIGINAL ARTICLE
The impact of radioactive iodine treatment on survival among papillary thyroid cancer patients according to the 7th and 8th editions of the AJCC/TNM staging system: a SEER‑based study Xiangxiang Liu1 · Yaguang Fan2 · Yuanchao Liu3 · Xianghui He3 · Xiangqian Zheng4 · Jian Tan1 · Qiang Jia1 · Zhaowei Meng1 Received: 30 January 2020 / Accepted: 16 April 2020 © Italian Society of Surgery (SIC) 2020
Abstract Papillary thyroid cancer is a very common endocrine malignancy. The 8th American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) staging system introduced major changes. We conducted this retrospective cohort analysis to assess the benefits of radioactive iodine (RAI) according to different stratification of patients. The source of the data was the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database. From 2006 to 2015, patients with papillary thyroid cancer were included in our study. The interactions between different variables and RAI treatment were tested by multivariate Cox regression models to compare the survival differences according to RAI treatment between the patients assessed with the 7th and 8th edition of the AJCC/TNM staging system. The results of the interaction analysis and group comparisons indicated that the effects of RAI treatment on patients staged with the 7th and 8th editions were similar. Patients with early Stage, early T stage, N0 and subtotal or near total thyroidectomy benefited greatly from RAI treatment. Patients with Stage III according to the 8th edition benefited less from RAI than patients with Stage III according to the 7th edition. Patients with T1a benefited from RAI but benefited less than patients with other T stages. Patients with T3a benefited more from RAI than those with T3b. According to the 8th edition, Stage III/IV more accurately differentiates patients with advanced stage disease. These patients benefitted less from RAI treatment, which may be due to the relatively weaker iodine uptake by tumor cells. T1a patients benefitted less than patients with other T stages. The difference in RAI benefit between patients with T3a and T3b is a novel finding in our study. Keywords Papillary thyroid cancer · Iodine radioisotopes · TNM staging systems · Survival · Prognoses
Introduction Xiangxiang Liu and Yaguang Fan as co-first authors contributed equally in the paper. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s13304-020-00773-y) contains supplementary material, which is available to authorized users. * Zhaowei Meng [email protected] 1
Department of Nuclear Medicine, Tianjin Medical University General Hospital, Anshan Road No. 154, Heping District, Tianjin 300052, People’s Republic of China
Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, People’s Republic of China
2
Thyroid cancer is the most common malignancy of the endo
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