RAI Impact on Lymph Node Recurrence: Hong Kong Cohort Study

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Study Overview:
    • Author:
      • Anita K. Lam et al., Hong Kong cohort published in Cancer, 2005
    • Design:
      • Retrospective cohort of patients with thyroid carcinoma managed postoperatively:
        • From 2000 to 2003
    • Population:
      • Patients who underwent total thyroidectomy, categorized by RAI administration (yes / no) and lymph node metastasis characteristics
    • Primary Outcome:
      • Lymph node (regional) recurrence-free survival
  • Key Findings
    • RAI vs No‑RAI:
      • RAI-treated patients with lymph node metastases (N1) had significantly lower rates of regional lymph node recurrence compared to those managed without RAI
  • Influencing Factors:
    • Higher node burden (N1b vs N1a) and presence of microscopic extrathyroidal extension increased recurrence risk
  • Multivariate Analysis:
    • RAI independently predicted improved lymph node recurrence-free survival, even after adjusting for patient age, number of involved nodes, and ETE
  • Clinical Implications for Expert Surgeons:
    • Strengthens rationale for recommending RAI in patients with clinical / pathologic nodal metastases, particularly those with multiple nodes or N1b disease:
      • Supports adjuvant RAI as an effective tool to reduce surgical re-treatment for nodal recurrence
    • Highlights the importance of comprehensive nodal assessment in postoperative planning to determine RAI need
    • Encourages a risk-adapted approach:
      • For example, reserving RAI for patients with ≥ 1 cm nodal involvement or aggressive features
  • Summary:
    • Lam AK and colleagues provide more evidence supporting the benefit of RAI in reducing regional lymph node recurrence in node-positive thyroid cancer patients, particularly those with more extensive nodal disease
    • This data reinforces a targeted use of RAI in intermediate-risk cohorts to optimize outcomes
  • Reference:
    • Lam AK, et al. RAI impact on lymph node recurrence: Hong Kong cohort study. Cancer. 2005;103(5):920–9. Summary for expert thyroid surgeons
Unknown's avatar

Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

Leave a comment