Should We Routinely Offer a Second Admission for Radioiodine to Patients with High-risk Differentiated Thyroid Cancer?
Received 1 October 2009; received in revised form 14 December 2009; accepted 21 December 2009.
Abstract
Aims
To assess whether an elective second admission for radioiodine is useful for patients with high-risk differentiated thyroid cancer (DTC).
Materials and methods
A retrospective analysis was carried out on 47 high-risk DTC patients treated with a second admission for radioiodine at our centre during the 2007–2008 period.
Results
In 21 patients (45%), the surgeon described an incomplete resection. Twenty-six (55%) had surgical macroscopic complete resection, but cancer cells at the margin of excision histologically. Overall, at the second admission for radioiodine, 27 patients (57%) had a normal post-treatment scan and undetectable thyroid-stimulating hormone (TSH) stimulated thyroglobulin. Twenty patients (43%) had raised stimulated thyroglobulin at second admission for radioiodine, of whom only six (13%) had abnormal uptake (>0.1%) on the post-treatment scan.
Conclusions
A second admission for radioiodine could have been avoided in most patients. Instead, information from stimulated thyroglobulin and a diagnostic radioiodine scan would have been sufficient to guide further management. This study also provides interesting outcome data on incompletely resected DTC.
St James Institute of Oncology, St James's Hospital, Becket Street, Leeds LS9 7TF, UK
Author for correspondence: G.E. Gerrard, St James Institute of Oncology, St James's Hospital, Becket Street, Leeds LS9 7TF, UK. Tel: +44-113-2068336; Fax: +44-113-2067534.
ABSTRACT