RAI for node negative PTC with capsular invasion only

Here's a new study which found that RAI treatment doesn't affect the recurrence rate for patients with microscopic capsular invasion:

http://onlinelibrary.wiley.com/doi/10.1111/ajco.12159/abstract;jsessionid=C 8E8BD1F53EC125912D7470200CA70B0.f03t04?deniedAccessCustomisedMessage=&userI sAuthenticated=false

Keywords:

• capsular invasion;
• papillary thyroid carcinoma;
• radioactive iodine ablation;
• recurrence

Abstract

Aim

With thyroid carcinoma the decision to use radioactive iodine (RAI) ablation depends on the risk of poor outcomes. Although extrathyroid extension (ETE) is well known as a risk of poor outcomes for papillary thyroid carcinoma (PTC), the definition of minimal ETE is too broad, as it encompasses both microscopic invasion of the thyroid capsule (capsular invasion [CI]) and macroscopic invasion of the sternothyroid muscle.

Methods

We conducted a retrospective study to analyze the prognostic benefit of RAI ablation according to the presence of CI in a consecutive series of patients with PTC between October 1997 and December 2008. We studied two groups of patients, including those who received RAI (group I, n = 121) and those who did not (group II, n = 108). During follow-up, we assessed the locoregional recurrence of all patients.

Results

There were no statistically significant difference between the groups regarding locoregional recurrence at follow-up (13.2% for group I vs 9.3% for group II, P = 0.441). The association between RAI and locoregional recurrence in PTC patients with CI remained insignificant after adjusting for potential confounders, such as age, tumor size, sex, lymphatic invasion, vascular invasion and tumor multiplicity (P = 0.409, hazard ratio = 0.698, 95% confidence interval, 0.298–1.639).

Conclusions

This retrospective study suggests that RAI treatment is not associated with less locoregional recurrence in PTC patients who only demonstrate CI, although further prospective studies are required to confirm these findings.