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ISRN Endocrinology
Volume 2012 (2012), Article ID 816386, 6 pages
http://dx.doi.org/10.5402/2012/816386
Research Article

Radioactive Iodine Therapy Decreases Recurrence in Thyroid Papillary Microcarcinoma

1Department of Radiation Oncology, Washington University School of Medicine, 4921 Parkview Place, Mailstop no. 90-38-635, St. Louis, MO 63110, USA
2Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8223, St. Louis, MO 63110, USA
3Department of Otolaryngology Head and Neck Surgery, Washington University School of Medicine, McMillan Hospital, 517 S. Euclid Avenue, St. Louis, MO 63110, USA
4Division of Nuclear Medicine, Department of Radiation Oncology, The Alvin J. Siteman Cancer Center, Mallinckrodt Institute of Radiology, Washington University School of Medicine, 4921 Parkview Place, Mailstop #90-38-635, St. Louis, MO 63110, USA

Received 10 October 2011; Accepted 24 November 2011

Academic Editors: J. NedvΓ­dkovΓ‘ and D. T. Papadimitriou

Copyright © 2012 Kimberly M. Creach et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The most appropriate therapy for papillary microcarcinoma (PMC) is controversial. Methods. We reviewed the therapy and outcome of 407 patients with PMC. Results. Three hundred-eighty patients underwent total thyroidectomy, and 349 patients received I-131 therapy. The median followup was 5.3 years. Forty patients developed recurrent disease. On univariate analysis, development of disease recurrence was correlated with histological tumor size > 0.8 cm ( 𝑃 = 0 . 0 1 0 4 ), age < 45 years ( 𝑃 = 0 . 0 4 3 ), and no I-131 therapy ( 𝑃 < 0 . 0 0 0 1 ). On multivariate analysis, histological tumor size > 0.8 cm, positive lymph nodes, and no I-131 therapy were significant. The 5-year RFS for patients treated with I-131 was 95.0% versus 78.6% ( 𝑃 < 0 . 0 0 0 1 ) for patients not treated with I-131. Patients with lymph node metastasis who did not receive I-131 had a 5-year RFS of 42.9% versus 93.2% ( 𝑃 < 0 . 0 0 0 1 ) for patients who received I-131. Conclusions. Recommend I-131 remnant ablation for patients with PMC, particularly patients with lymph node metastasis.