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CLINICAL STUDY |
1 Departments of Nuclear Medicine and 2 Endocrinology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
(Correspondence should be addressed to F A Verburg, Burg. Allardstraat 254931 CA Geertruidenberg, The Netherlands; Email: e.verburg{at}azu.nl)
Objectives: Currently, little is known about the prognostic significance of achieving successful ablation with the first dosage of I-131 in patients with differentiated thyroid cancer. This study aimed to assess the following: (i) whether successful or unsuccessful ablation at post-ablation follow-up has prognostic consequences; (ii) possible factors predicting success of ablation in a patient.
Methods: In order to do this, we retrospectively studied 180 patients with a median follow-up of 55 months. Ablation was considered to be successful if 1 year after the initial dosage of I-131 patients fulfilled all of the following criteria: not dead from thyroid cancer, no additional therapy needed for any kind for thyroid cancer within the first year, undetectable thyroglobulin (Tg) levels under TSH stimulation, and negative I-131 scintigraphy. Tg levels at the time of ablation (P < .001), lymph node metastasis (P = 0.04) and distant metastasis (P < .001) have a significant influence on the success of ablation. P values were calculated by Mann–Whitney U test and Chi-square test, respectively.
Results: Patients with successful ablation had a better prognosis than those with unsuccessful ablation: disease-free survival was 87% versus 49% after 10 years; additionally, thyroid-cancer related survival was 93% versus 78%.
Conclusion: We conclude that the extent of the remaining normal or neoplastic thyroid tissue influences the outcome of ablation, and that successful ablation leads to a better prognosis. It seems that it is very important to achieve complete ablation as soon as possible in order to ensure the best possible prognosis for a patient.
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  R. B T Verkooijen, F. A Verburg, J. W van Isselt, C. J M Lips, J. W Smit, and M. P M Stokkel The success rate of I-131 ablation in differentiated thyroid cancer: comparison of uptake-related and fixed-dose strategies Eur. J. Endocrinol., September 1, 2008; 159(3): 301 - 307. [Abstract] [Full Text] [PDF]
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F. Pacini, M. Schlumberger, C. Harmer, G. G Berg, O. Cohen, L. Duntas, F. Jamar, B. Jarzab, E. Limbert, P. Lind, et al. Post-surgical use of radioiodine (131I) in patients with papillary and follicular thyroid cancer and the issue of remnant ablation: a consensus report Eur. J. Endocrinol., November 1, 2005; 153(5): 651 - 659. [Abstract] [Full Text] [PDF]
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