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Ablation rate after radioactive iodine therapy in patients with differentiated thyroid cancer at intermediate or high risk of recurrence: a systematic review and a meta-analysis

PURPOSE: We performed a systematic review and a meta-analysis to investigate the successful ablation rate after radioiodine (RAI) administration in patients with differentiated thyroid cancer (DTC) at intermediate-high risk of recurrence. METHODS: A comprehensive literature search of the PubMed, Sco...

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Detalles Bibliográficos
Autores principales: Klain, Michele, Nappi, Carmela, Zampella, Emilia, Cantoni, Valeria, Green, Roberta, Piscopo, Leandra, Volpe, Fabio, Manganelli, Mariarosaria, Caiazzo, Elisa, Petretta, Mario, Schlumberger, Martin, Cuocolo, Alberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8566414/
https://www.ncbi.nlm.nih.gov/pubmed/34142215
http://dx.doi.org/10.1007/s00259-021-05440-x
Descripción
Sumario:PURPOSE: We performed a systematic review and a meta-analysis to investigate the successful ablation rate after radioiodine (RAI) administration in patients with differentiated thyroid cancer (DTC) at intermediate-high risk of recurrence. METHODS: A comprehensive literature search of the PubMed, Scopus, and Web of Science databases was conducted according to the PRISMA statement. RESULTS: The final analysis included 9 studies accounting for 3103 patients at intermediate-high risk of recurrence. In these patients, the successful ablation rates ranged from 51 to 94% with a 71% pooled successful ablation and were higher in intermediate (72%) than in high (52%)-risk patients. Despite the rigorous inclusion standards, a significant heterogeneity among the evaluated studies was observed. Higher administered RAI activities are associated with a lower successful ablation rate in the whole population and in the subgroup of high-risk patients. Furthermore, pooled recurrence rate in intermediate-risk patients achieving successful ablation was only 2% during the subsequent 6.4-year follow-up while the pooled recurrence rate was 14% in patients who did not achieve a successful ablation. CONCLUSION: In a large sample of 3103 patients at intermediate-high risk of persistent/recurrent disease, 71% of patients achieved a successful ablation. In these intermediate-risk patients, the probability of subsequent recurrence is low and most recurrence occurred in those with already abnormal findings at the first control. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00259-021-05440-x.