Effect of adjuvant radioactive iodine therapy on survival in rare oxyphilic subtype of thyroid cancer (Hürthle cell carcinoma)
Purpose Radioactive iodine (RAI) is widely used for adjuvant therapy after thyroidectomy, while its value for thyroid cancer has been controversial recently. The primary objectives of this study were to clarify the influence of Radioactive iodine (RAI) on the survival in rare oxyphilic subtype of th...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
PeerJ Inc.
2019-08-01
|
Series: | PeerJ |
Subjects: | |
Online Access: | https://peerj.com/articles/7458.pdf |
_version_ | 1797419299783049216 |
---|---|
author | Qiong Yang Zhongsheng Zhao Guansheng Zhong Aixiang Jin Kun Yu |
author_facet | Qiong Yang Zhongsheng Zhao Guansheng Zhong Aixiang Jin Kun Yu |
author_sort | Qiong Yang |
collection | DOAJ |
description | Purpose Radioactive iodine (RAI) is widely used for adjuvant therapy after thyroidectomy, while its value for thyroid cancer has been controversial recently. The primary objectives of this study were to clarify the influence of Radioactive iodine (RAI) on the survival in rare oxyphilic subtype of thyroid cancer (Hürthle cell carcinoma, HCC). Methods Patients diagnosed with oxyphilic thyroid carcinoma from 2004 to 2015 were extracted from the Surveillance, Epidemiology, and End Results Program database. The Kaplan-Meier method was used to compare overall survival (OS) and cancer-specific survival (CSS) among patients who had adjuvant RAI use or not. Univariate and multivariate Cox proportional hazard models were performed for survival analysis, and subsequently visualized by nomogram. Results In all, 2,799 patients were identified, of which 1529 patients had adjuvant RAI use while 1,270 patients had not. Based on multivariate Cox analysis, the RAI therapy confers an improved OS for HCC patients (HR = 0.57, 95% CI [0.44–0.72], P < 0.001), whereas it has no significant benefit in the survival analysis regarding CSS (HR = 0.79, 95% CI [[0.47–1.34], P = 0.382). In a subgroup analysis, the same survival benefit of RAI treatment on OS, but not CSS was observed among patients stratified by AJCC stage and tumor extension. Nevertheless, patients with regional lymph node metastasis benefited from RAI therapy both in OS and CSS (P < 0.001, respectively). Furthermore, nomograms used for predicting long term survival of HCC patients exhibited a better prediction power for OS compared with traditional tumor, nodal and metastatic (TNM) stage made by American Joint Committee on Cancer (AJCC) (C-index = 0.833 of the nomogram model vs. 0.696 of the AJCC system). Conclusions This study suggests that RAI therapy is significantly associated with improved OS in patients with Hürthle cell carcinoma. However, there was no association between treatment with radioiodine and CSS, possibly due to small number of deaths that were related to HCC. |
first_indexed | 2024-03-09T06:45:22Z |
format | Article |
id | doaj.art-7dd574552c004af5a4dc7d5413223520 |
institution | Directory Open Access Journal |
issn | 2167-8359 |
language | English |
last_indexed | 2024-03-09T06:45:22Z |
publishDate | 2019-08-01 |
publisher | PeerJ Inc. |
record_format | Article |
series | PeerJ |
spelling | doaj.art-7dd574552c004af5a4dc7d54132235202023-12-03T10:36:16ZengPeerJ Inc.PeerJ2167-83592019-08-017e745810.7717/peerj.7458Effect of adjuvant radioactive iodine therapy on survival in rare oxyphilic subtype of thyroid cancer (Hürthle cell carcinoma)Qiong Yang0Zhongsheng Zhao1Guansheng Zhong2Aixiang Jin3Kun Yu4Department of Breast and Thyroid Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, P.R.ChinaDepartment of Pathology, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, P.R.ChinaDepartment of Breast and Thyroid Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, P.R.ChinaDepartment of Breast and Thyroid Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, P.R.ChinaDepartment of Head, Neck & Thyroid Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Hangzhou, Zhejiang, P.R.ChinaPurpose Radioactive iodine (RAI) is widely used for adjuvant therapy after thyroidectomy, while its value for thyroid cancer has been controversial recently. The primary objectives of this study were to clarify the influence of Radioactive iodine (RAI) on the survival in rare oxyphilic subtype of thyroid cancer (Hürthle cell carcinoma, HCC). Methods Patients diagnosed with oxyphilic thyroid carcinoma from 2004 to 2015 were extracted from the Surveillance, Epidemiology, and End Results Program database. The Kaplan-Meier method was used to compare overall survival (OS) and cancer-specific survival (CSS) among patients who had adjuvant RAI use or not. Univariate and multivariate Cox proportional hazard models were performed for survival analysis, and subsequently visualized by nomogram. Results In all, 2,799 patients were identified, of which 1529 patients had adjuvant RAI use while 1,270 patients had not. Based on multivariate Cox analysis, the RAI therapy confers an improved OS for HCC patients (HR = 0.57, 95% CI [0.44–0.72], P < 0.001), whereas it has no significant benefit in the survival analysis regarding CSS (HR = 0.79, 95% CI [[0.47–1.34], P = 0.382). In a subgroup analysis, the same survival benefit of RAI treatment on OS, but not CSS was observed among patients stratified by AJCC stage and tumor extension. Nevertheless, patients with regional lymph node metastasis benefited from RAI therapy both in OS and CSS (P < 0.001, respectively). Furthermore, nomograms used for predicting long term survival of HCC patients exhibited a better prediction power for OS compared with traditional tumor, nodal and metastatic (TNM) stage made by American Joint Committee on Cancer (AJCC) (C-index = 0.833 of the nomogram model vs. 0.696 of the AJCC system). Conclusions This study suggests that RAI therapy is significantly associated with improved OS in patients with Hürthle cell carcinoma. However, there was no association between treatment with radioiodine and CSS, possibly due to small number of deaths that were related to HCC.https://peerj.com/articles/7458.pdfRadioactive iodineHürthle Cell CarcinomaSEERSurvival |
spellingShingle | Qiong Yang Zhongsheng Zhao Guansheng Zhong Aixiang Jin Kun Yu Effect of adjuvant radioactive iodine therapy on survival in rare oxyphilic subtype of thyroid cancer (Hürthle cell carcinoma) PeerJ Radioactive iodine Hürthle Cell Carcinoma SEER Survival |
title | Effect of adjuvant radioactive iodine therapy on survival in rare oxyphilic subtype of thyroid cancer (Hürthle cell carcinoma) |
title_full | Effect of adjuvant radioactive iodine therapy on survival in rare oxyphilic subtype of thyroid cancer (Hürthle cell carcinoma) |
title_fullStr | Effect of adjuvant radioactive iodine therapy on survival in rare oxyphilic subtype of thyroid cancer (Hürthle cell carcinoma) |
title_full_unstemmed | Effect of adjuvant radioactive iodine therapy on survival in rare oxyphilic subtype of thyroid cancer (Hürthle cell carcinoma) |
title_short | Effect of adjuvant radioactive iodine therapy on survival in rare oxyphilic subtype of thyroid cancer (Hürthle cell carcinoma) |
title_sort | effect of adjuvant radioactive iodine therapy on survival in rare oxyphilic subtype of thyroid cancer hurthle cell carcinoma |
topic | Radioactive iodine Hürthle Cell Carcinoma SEER Survival |
url | https://peerj.com/articles/7458.pdf |
work_keys_str_mv | AT qiongyang effectofadjuvantradioactiveiodinetherapyonsurvivalinrareoxyphilicsubtypeofthyroidcancerhurthlecellcarcinoma AT zhongshengzhao effectofadjuvantradioactiveiodinetherapyonsurvivalinrareoxyphilicsubtypeofthyroidcancerhurthlecellcarcinoma AT guanshengzhong effectofadjuvantradioactiveiodinetherapyonsurvivalinrareoxyphilicsubtypeofthyroidcancerhurthlecellcarcinoma AT aixiangjin effectofadjuvantradioactiveiodinetherapyonsurvivalinrareoxyphilicsubtypeofthyroidcancerhurthlecellcarcinoma AT kunyu effectofadjuvantradioactiveiodinetherapyonsurvivalinrareoxyphilicsubtypeofthyroidcancerhurthlecellcarcinoma |