In:
Clinical Endocrinology, Wiley, Vol. 83, No. 1 ( 2015-07), p. 117-123
Abstract:
The aim of this study was to investigate the risk factors for second primary malignancy ( SPM ) diagnosed after differentiated thyroid cancer ( DTC ). Methods A total of 2468 DTC patients who underwent thyroidectomy were reviewed. SPM was defined as a non‐thyroidal malignancy, diagnosed at least 1 year after the diagnosis of thyroid cancer. Patients were divided into five groups according to cumulative 131 I dose: very high‐activity (≥37·0 GB q), high‐activity (22·3–36·9 GB q), intermediate‐activity (5·56–22·2 GB q), low‐activity (1·1–5·55 GB q) and no RAI . Results Among the 2468 patients, 61 (2·5%) had SPM s during 7·0 (1·0–33·0) years of median follow‐up. Age above 40 years, male sex and very high‐activity RAI were independent risk factors for the development of SPM . SPM ‐related mortality was highest in the very high‐activity group, while DTC ‐related mortality was highest in the high‐activity group. The overall mortality both from SPM and DTC was highest in the high‐activity group. Conclusion A cumulative 131 I dose 〈 37·0 GB q did not increase the risk of SPM . A cumulative 131 I dose ≥37·0 GB q increased the risk of SPM and SPM ‐related mortality and decreased the DTC ‐specific mortality, resulting in a similar all‐cause mortality compared with the low‐activity RAI group. Using repeated high‐dose RAI for treating RAI ‐responsive but persistent DTC patients needs careful consideration of the individual benefits from RAI vs the risk of developing SPM .
Type of Medium:
Online Resource
ISSN:
0300-0664
,
1365-2265
DOI:
10.1111/cen.2015.83.issue-1
Language:
English
Publisher:
Wiley
Publication Date:
2015
detail.hit.zdb_id:
121745-8
detail.hit.zdb_id:
2004597-9
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