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Radioiodine remnant ablation in papillary thyroid microcarcinoma

a meta-analysis

Yang, Tinga; Zheng, Shi-Yangb; Jiao, Jua; Zou, Qionga; Zhang, Yonga

Nuclear Medicine Communications: July 2019 - Volume 40 - Issue 7 - p 711–719
doi: 10.1097/MNM.0000000000001018

Background The incidence of papillary thyroid microcarcinoma (PTMC) has been increasing sharply, the current statement about whether PTMC patients should undergo radioactive iodine (RAI) remnant ablation is still controversial, mainly because it is uncertain whether RAI treatment can reduce the recurrence rate.

Objective To evaluate the effectiveness of RAI remnant ablation for thyroid cancer-related outcomes of PTMC patients.

Methods We comprehensively searched PubMed, Cochrane Library, Scopus and Science Direct for studies that compared the effectiveness after total-thyroidectomy or near total-thyroidectomy, with or without RAI remnant ablation treatment. Random and fixed-effects meta-analytical models were used where indicated, and between-study heterogeneity was assessed.

Results Twenty-two studies, which included 8724 patients, met our search criteria and were assessed. For PTMC patients treated by total thyroidectomy or near-total thyroidectomy, the locoregional recurrence rates were 1.92 and 7.36% [risk ratio (RR)=0.45; 95% confidence interval (CI)=0.18–1.11; P=0.08] for patients with or without RAI treatment respectively, the distant metastasis rates were 1.39 and 2.46% (RR=0.64; 95% CI=0.28–1.48; P=0.30), and the thyroid cancer-related mortality rates were 0.98 and 1.76% (RR=0.68; 95% CI=0.22–2.09; P=0.50).

Conclusion For PTMC patients who have already treated by total thyroidectomy or near-total thyroidectomy, incremental RAI remnant ablation may significantly improve thyroid cancer-related outcomes.

Departments of aNuclear Medicine

bThyroid and Breast Surgery, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

Correspondence to Yong Zhang, PhD, Department of Nuclear Medicine, Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Tianhe District, Guangzhou 510630, Guangdong, China Tel: +86 189 221 02761; fax: +86 020 8525 3336; e-mail:

Received October 25, 2018

Accepted March 18, 2019

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.