Abstract
Role and Associated Disparities in the Utilization of Radioiodine Therapy and Total Thyroidectomy in Patients with Low-Risk Thyroid Cancer
Journal of the American College of Surgeons, Vol.223(4), pp.S145-S145
10/2016
DOI: 10.1016/j.jamcollsurg.2016.06.310
Abstract
Introduction
Recent American Thyroid Association (ATA) guidelines recommend against the use of radioiodine therapy (RAI) in thyroid cancer patients with low risk of recurrence. In this study, we aimed to examine the pattern of use of RAI and total thyroidectomy (TT) in relation to population characteristics and their survival benefit.
Methods
A retrospective cohort study was performed using the National Cancer Data Base, 2004–2012. The study population included adult (≥18 years) patients with low-risk thyroid cancer based on ATA criteria, who underwent thyroid surgery.
Results
A total of 11,599 patients were identified; median follow-up time was 29.3 months (interquartile range 19.8–39.8 months). RAI was used in 5,282 (45.5%) subjects without significant change in the use rate over the study period (p=0.06). RAI did not associate with an overall survival benefit in the adjusted model (hazard ratio 0.70, 95% CI [0.38-1.28], p=0.25). RAI was most likely to be administered to patients who are male, white, and/or had private insurance (p<0.05 each). TT was performed in 10,001 (86.2%) subjects. Similarly, TT did not result in a survival advantage compared with a unilateral procedure (hazard ratio 0.53, 95% CI [0.28-1.02], p=0.06). TT was performed mostly in patients who are male and/or treated in a high-volume hospital (p<0.05 each).
Conclusions
RAI and TT are widely used in low-risk population; nonetheless, they demonstrate no survival advantage. Furthermore, there are demographic and economic disparities in the use of both modules. Applying the recent ATA guideline would protect patients from unnecessary exposure to radiation.
Details
- Title: Subtitle
- Role and Associated Disparities in the Utilization of Radioiodine Therapy and Total Thyroidectomy in Patients with Low-Risk Thyroid Cancer
- Creators
- Zaid Al-QurayshiSudesh K. Srivastav - Tulane UniversityEmad Kandil - Tulane University
- Resource Type
- Abstract
- Publication Details
- Journal of the American College of Surgeons, Vol.223(4), pp.S145-S145
- Publisher
- ELSEVIER SCIENCE INC
- DOI
- 10.1016/j.jamcollsurg.2016.06.310
- ISSN
- 1072-7515
- eISSN
- 1879-1190
- Language
- English
- Date published
- 10/2016
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984702775602771
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