Regional Variation across Canadian Centers in Radioiodine Administration for Thyroid Remnant Ablation in Well-Differentiated Thyroid Cancer Diagnosed in 2000–2010

Abstract

Background. Use of radioactive iodine (RAI) ablation has been reported to vary significantly between studies. We explored variation in RAI ablation care patterns between seven thyroid cancer treatment centers in Canada. Methods. The Canadian Collaborative Network for Cancer of the Thyroid (CANNECT) is a collaborative registry to describe and analyze patterns of care for thyroid cancer. We analyzed data from seven participating centers on RAI ablation in patients diagnosed with well-differentiated (papillary and follicular) thyroid cancer between 2000 and 2010. We compared RAI ablation protocols including indications (based on TNM staging), preparation protocols, and administered dose. We excluded patients with known distant metastases at time of RAI ablation. Results. We included 3072 patients. There were no significant differences in TNM stage over time. RAI use increased in earlier years and then declined. The fraction of patients receiving RAI varied significantly between centers, ranging between 20–85% for T1, 44–100% for T2, 58–100% for T3, and 59–100% for T4. There were significant differences in the RAI doses between centers. Finally, there was major variation in the use of thyroid hormone withdrawal or rhTSH for preparation of RAI ablation. Conclusion. Our study identified significant variation in use of RAI for ablation in patients with well-differentiated thyroid cancer both between Canadian centers and over time.

Real-World Performance of the American Thyroid Association Risk Estimates in Predicting 1-Year Differentiated Thyroid Cancer Outcomes: A Prospective Multicenter Study of 2000 Patients

“…Inter-institutional and inter-observer variabilities have been reported in the diagnosis of histological subtypes (24), the detection and quantification of extrathyroidal extension (25), neck ultrasonographic examination (26), and various aspects of RAI administration, including indications, the amount of activity administered, and the method used to ensure appropriately elevated TSH levels at the time of RAI therapy (withdrawal of thyroid hormone replacement therapy vs. rhTSH injections) (27). Treatment centers also vary widely in the number of thyroidectomies performed by their staff each year and this factor is a well-established predictor of outcome (28,29).…”

Decline in radioiodine use but not total thyroidectomy in thyroid cancer patients treated in the United Arab Emirates - A retrospective study

“…However, data on RAI indication in our study was not captured, therefore, precluding firm conclusions. Additionally, variation in RAI use is well reported in many countries such as the US and Canada [ 33 , 34 ]. Of interest, the use of RAI for example in T1 disease with unknown or negative lymph node status varied between 15 and 83% among different centers in Canada [ 34 ].…”

“…Additionally, variation in RAI use is well reported in many countries such as the US and Canada [ 33 , 34 ]. Of interest, the use of RAI for example in T1 disease with unknown or negative lymph node status varied between 15 and 83% among different centers in Canada [ 34 ]. This wide variation in RAI use underscores the limited data and uncertainty in the management of a significant proportion of TC patients, necessitating the need for high-quality studies with long term follow up data to confidently guide management in such patients.…”

Effect of radioiodine therapy (131I) on blood cells of differentiated thyroid carcinoma patients

“…Nghiên cứu của tác giả Mousa, Yilmaz AS và Nar A Một nghiên cứu khác trong khoảng thời gian từ tháng 1/2000 đến 12/2010 trên 393 bệnh nhân UTTG nguy cơ thấp hoặc trung bình cho thấy 92,1% bệnh nhân có ghi nhận là UTBMTG thể nhú (Mousa U et al, 2014). Tương tự, nghiên cứu của Rachinsky et al (2016), trong năm 2000 -2010 trên 3072 bệnh nhân UTTG cho thấy UTBMTG được tìm thấy trên 93,6% bệnh nhân nghiên cứu. Ở một nghiên cứu khác, thể nang 0,9%; thể nhú 93,8% và thể hỗn hợp nang nhú 5,3% (Lê Thị Hồng Giang, 2017).…”