title: The Effectiveness of Radioactive Iodine Remnant Ablation for Papillary Thyroid Microcarcinoma: A Systematic Review and Meta-analysis.
abstract: BACKGROUND
  This systematic review and meta-analysis aimed to evaluate the effectiveness of radioactive iodine (RAI) remnant ablation for thyroid cancer-related outcomes of patients with papillary thyroid microcarcinoma (PTMC).
  
  
  METHODS
  A systematic literature search of PubMed, EMBASE OvidSP, and EBSCO was conducted. Studies were selected that provided multivariable analysis of the effectiveness of RAI ablation or provided specific data of a 10 years history of thyroid cancer-related outcomes in patients that presented with PTMC.
  
  
  RESULTS
  Nineteen studies met the inclusion criteria. A multivariable analysis of the effectiveness of RAI ablation for any recurrence or thyroid cancer-related mortality in patients with PTMC was performed in several studies, among which only one study reported a positive result. Furthermore, for PTMC patients treated by total or near-total thyroidectomy (TT/NT), with or without RAI ablative therapy, the meta-analysis suggested that RAI ablation did not decrease the 10 years history of any tumor recurrence (relative risk [RR] 0.96; 95% confidence interval [CI] 0.63-1.48; P = 0.87), locoregional recurrence (RR 1.15; 95% CI 0.75-1.76; P = 0.51), distant metastases (RR 0.32; 95% CI 0.08-1.32; P = 0.11) or thyroid cancer-related mortality (RR 0.76; 95% CI 0.22-2.63; P = 0.66).
  
  
  CONCLUSIONS
  With regard to multivariable analyses, there was almost no positive treatment effect of RAI ablation noted for patients with PTMC. For PTMC patients already treated by TT/NT, incremental RAI ablation may not be beneficial at decreasing the 10 years recurrence of PTMC or incidence of thyroid cancer-related mortality.
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. hu.guangfu@zs-hospital.sh.cn.
authors.forename: Guangfu
authors.initials: G
authors.lastname: Hu
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. zhu.wei1@zs-hospital.sh.cn.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhu
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. yang.weige@zs-hospital.sh.cn.
authors.forename: Weige
authors.initials: W
authors.lastname: Yang
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. wang.hong@zs-hospital.sh.cn.
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. 146381536@qq.com.
authors.forename: Lei
authors.initials: L
authors.lastname: Shen
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. zhang.hongwei@zs-hospital.sh.cn.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Zhang
mesh_terms: D002291:Carcinoma, Papillary / Q000601:surgery*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D009364:Neoplasm Recurrence, Local; D016634:Radiosurgery / Q000379:methods*; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*
chemical_list: D007457:Iodine Radioisotopes