Radioactive Iodine Therapy Does not Improve Cancer-specific Survival in Hürthle Cell Carcinoma of the Thyroid

J Clin Endocrinol Metab. 2022 Nov 23;107(11):3144-3151. doi: 10.1210/clinem/dgac448.

Abstract

Context: It is unclear whether radioactive iodine (RAI) therapy could improve cancer-specific survival (CSS) in patients with Hürthle cell carcinoma (HCC) of the thyroid.

Objective: To investigate the effect of RAI on CSS in HCC patients.

Methods: HCC patients who underwent total thyroidectomy (TT) were identified from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2018. The Kaplan-Meier method and the Cox proportional hazards regression model were used to evaluate CSS. Propensity score-matched (PSM) analyses were performed to control the influence of potential confounders.

Results: A total of 2279 patients were identified. RAI treatment was not significantly associated with improved CSS in overall or PSM cohort. Subgroup analyses indicated similar results, even in patients with aggressive features such as age 55 years or older, tumor size greater than 40 mm, distant disease in SEER staging, extrathyroidal extension, and lymph node metastases (all P > .05).

Conclusion: RAI has no statistically significant influence on the CSS in HCC patients. This information may aid in decision-making for RAI therapy in these patients.

Keywords: Hürthle cell carcinoma; SEER program; propensity score; radioactive iodine; survival; thyroid cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carcinoma, Hepatocellular*
  • Humans
  • Iodine Radioisotopes / therapeutic use
  • Liver Neoplasms*
  • Middle Aged
  • Thyroid Neoplasms* / radiotherapy
  • Thyroid Neoplasms* / surgery

Substances

  • Iodine Radioisotopes

Supplementary concepts

  • Thyroid cancer, Hurthle cell