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.
St James Institute of Oncology, St James's Hospital, Leeds, UK. georgina.gerrard@leedsth.nhs.uk
G E
GE
Gerrard
L
L
O'Toole
F
F
Roberts
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