ccording to the findings of scientists, the addition rate of radioactive iodine to the second operation in papillary thyroid carcinoma does not provide clinical benefit. The data is based on analysis of more than 100 patients undergoing reoperation because of recurrence was made.
The study found that patients showed a decrease in tumor marker levels, regardless of whether they have undergone. The study also showed that one transaction was less recurrence compared with those who also held an additional therapy, which was conducted among patients. The work is published in JAMA Surgery.
According to study author Michael W. Yeh, MD, School of Medicine, David Geffen University of California, Los Angeles, radioactive iodine is associated with an increase in the frequency of the spread of blood cancer, problems with salivary glands and tear channels, as well as the problems of pregnancy among women who are treatment after 35 years.
Scientists have tried to find out whether the level is reduced thyroglobulin (Tg) to a normal level after repeated operation. Michael Tuttle, a researcher, said that they continued therapy, but with oncological point of view it does not make sense. Although radioactive iodine treatment is recommended after initial thyroidectomy in patients with high risk of recurrence, its role after re-operation is not clear.
The researchers examined the medical records of the Integrated Clinical Research and the University of California at data warehouse 102 patients, which in the period from 2006 to 2016. We made a second operation. The average age of patients was 44 years, and 66% of them - women. Fifty patients after taking iodine, and 52 underwent reoperation without subsequent course. During a second operation the total number of remote lymph was similar in all patients.
In both groups decreased Tg levels immediately before the retransmission operation. Patients who have undergone reception iodine, more likely was a relapse after repeated operation. Wherein a significant difference in survival without relapse was not after re-operation between the two groups. Analysis of patients showed no benefits of therapy after repeated operation.
The researchers stressed that the work has limiting factors. This is due to the fact that patients treated with iodine, were more inclined to the choice of therapy based on clinical signs, which have been associated with a higher risk of relapse. Moreover, the study was conducted only in one center, which limits the information on clinical events before surgery.