title: Adjuvant radioactive therapy after reoperation for locoregionally recurrent papillary thyroid cancer in patients who initially underwent total thyroidectomy and high-dose remnant ablation.
abstract: BACKGROUND
  Some patients have elevated stimulated thyroglobulin (sTg) concentrations after reoperation for locoregionally recurrent/persistent papillary thyroid cancer (PTC). Little is known, however, about the efficacy of adjuvant radioactive iodine (RAI) therapy in these patients.
  
  
  OBJECTIVE
  The objective of the study was to evaluate the efficacy of adjuvant RAI therapy in patients with elevated sTg after reoperation for locally recurrent/persistent PTC.
  
  
  METHODS
  This was a retrospective observational cohort study in a tertiary referral hospital.
  
  
  METHODS
  We evaluated 45 consecutive patients with sTg greater than 2 ng/ml after reoperation for locoregionally recurrent PTC, all of whom had previously undergone initial total thyroidectomy followed by high-dose RAI remnant ablation. Of these 45 patients, 23 received adjuvant RAI therapy (adjuvant group) and 22 did not (control group).
  
  
  METHODS
  Main outcome measures included changes in sTg concentration after reoperation and disease-free survival.
  
  
  RESULTS
  Over time, there were no significant differences in mean sTg concentration in the adjuvant (P = 0.35) and control (P = 0.74) groups. Only 15% of patients in the adjuvant group and 33% in the control group showed a greater than 50% decrease in sTg level from baseline. There were no between-group differences in changes (P = 0.83) or percent decrease (P = 0.97) in sTg concentration and no difference in clinical recurrence-free survival (P = 0.20).
  
  
  CONCLUSIONS
  In patients who still have elevated sTg after reoperation for locally recurrent/persistent PTC, adjuvant RAI therapy compared with no additional RAI therapy resulted in no significant differences in the subsequent sTg changes or the recurrence-free survival.
authors: Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyeongwongil, Songpa-gu, Seoul 138-736, Korea.
authors: Ji Hye
authors: JH
authors: Yim
authors: Won Bae
authors: WB
authors: Kim
authors: Eui Young
authors: EY
authors: Kim
authors: Won Gu
authors: WG
authors: Kim
authors: Tae Yong
authors: TY
authors: Kim
authors: Jin-Sook
authors: JS
authors: Ryu
authors: Dae Hyuk
authors: DH
authors: Moon
authors: Tae-Yon
authors: TY
authors: Sung
authors: Jong Ho
authors: JH
authors: Yoon
authors: Seong Chul
authors: SC
authors: Kim
authors: Suck Joon
authors: SJ
authors: Hong
authors: Young Kee
authors: YK
authors: Shong
mesh_terms: D000328:Adult; D002291:Carcinoma, Papillary / Q000097:blood / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000532:radiotherapy* / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D013954:Thyroglobulin / Q000097:blood; D013964:Thyroid Neoplasms / Q000097:blood / Q000532:radiotherapy* / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome
chemical_list: D013954:Thyroglobulin