Should we routinely offer a second admission for radioiodine to patients with high-risk differentiated thyroid cancer?
OBJECTIVE
To assess whether an elective second admission for radioiodine is useful for patients with high-risk differentiated thyroid cancer (DTC).


METHODS
A retrospective analysis was carried out on 47 high-risk DTC patients treated with a second admission for radioiodine at our centre during the 2007-2008 period.


RESULTS
In 21 patients (45%), the surgeon described an incomplete resection. Twenty-six (55%) had surgical macroscopic complete resection, but cancer cells at the margin of excision histologically. Overall, at the second admission for radioiodine, 27 patients (57%) had a normal post-treatment scan and undetectable thyroid-stimulating hormone (TSH) stimulated thyroglobulin. Twenty patients (43%) had raised stimulated thyroglobulin at second admission for radioiodine, of whom only six (13%) had abnormal uptake (>0.1%) on the post-treatment scan.


CONCLUSIONS
A second admission for radioiodine could have been avoided in most patients. Instead, information from stimulated thyroglobulin and a diagnostic radioiodine scan would have been sufficient to guide further management. This study also provides interesting outcome data on incompletely resected DTC.
Gerrard
G E
GE
St James Institute of Oncology, St James's Hospital, Leeds, UK. georgina.gerrard@leedsth.nhs.uk
O'Toole
L
L
Roberts
F
F
D000231:Adenocarcinoma, Papillary / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000532:radiotherapy*; D002454:Cell Differentiation / Q000528:radiation effects*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D016609:Neoplasms, Second Primary / Q000517:prevention & control; D010166:Palliative Care; D011379:Prognosis; D011836:Radiation Tolerance / Q000528:radiation effects*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012307:Risk Factors; D013954:Thyroglobulin / Q000032:analysis; D013964:Thyroid Neoplasms / Q000532:radiotherapy*; D016896:Treatment Outcome; D055815:Young Adult
D007457:Iodine Radioisotopes; D013954:Thyroglobulin