Radioactive Iodine Therapy and Survival Among Patients With Intermediate-Risk Differentiated Thyroid Cancer: A SEER Analysis.

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Study Overview:
    • Study:
      • Zeng R, et al. Radioactive Iodine Therapy and Survival Among Patients With Intermediate-Risk Differentiated Thyroid Cancer: A SEER Analysis
    • Journal:
    • Database:
      • SEER (2010 to 2015)
    • Population:
      • Patients with intermediate-risk DTC after total thyroidectomy (no distant metastases)
    • Design:
      • Retrospective cohort study using stabilized inverse probability of treatment weighting (sIPTW) to adjust for selection bias
    • Key Findings:
      • Cancer-Specific Survival (CSS):
        • RAIT was associated with a 41% reduction in thyroid cancer–specific mortality:
          • Hazard Ratio (HR): 0.59 (95% CI, 0.44–0.80; p = 0.0019)
      • Overall Survival (OS):
        • Significantly better in patients who received RAIT (p < 0.0001)
      • Age Stratification (using AJCC 8th edition cutoff of 55 years):
        • In patients ≥ 55 years;
          • RAIT was significantly associated with improved CSS (p = 0.0045)
        • Age ≥55 was an independent negative prognostic factor (HR ~8.9)
  • Clinical Implications for Thyroid Surgeons:
    • Level of Evidence:
      • Level II:
        • Well-adjusted large retrospective cohort
    • Key Recommendation:
      • In intermediate-risk DTC:
        • RAIT should be strongly considered, especially in patients ≥55 years or those with multiple adverse features:
          • Such as microscopic extrathyroidal extension, lymph node involvement
    • Clinical Application:
      • Supports risk-adapted RAIT strategies as outlined in ATA 2015 guidelines
  • Expert Takeaway:
    • This SEER-based 2024 study reinforces that RAIT offers a survival advantage in intermediate-risk DTC, especially for older patients
    • The findings provide crucial evidence to support more precise, individualized RAI recommendations within a multidisciplinary framework
  • References:
    • Haugen BR, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1–133. doi:10.1089/thy.2015.0020
    • Zeng R, et al. Radioactive Iodine Therapy and Survival Among Patients With Intermediate-Risk Differentiated Thyroid Cancer: A SEER Analysis. Thyroid. 2024;34(6):700–710. doi:10.1089/thy.2023.0656 PMID: 38809346
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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.

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