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Acharya SH, Avenell A, Philip S, Burr J, Bevan J, Abraham P: Radioiodine therapy for Graves’ disease and the effect on ophthalmopathy: a systematic review. Clin Endocrinol 2008;69:943–950. 10.1111/j.1365-2265.2008.03279.x 18429949 7 Tallstedt L
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diagnosis of papillary thyroid cancer and 9 of follicular thyroid cancer; 29 patients had 1 radioiodine therapy and 38 had subsequent radioiodine therapies for remnant, recurrence or metastatic disease. The prescribed activity of 131 I which patients
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Department of Clinical Pharmacology, Bispebjerg Hospital
Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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University Hospital, and Laszlo Hegedüs is supported by an unrestricted grant from the Novo Nordisk Foundation. Disclosure Statement All authors declare no conflicts of interest. References 1 Bonnema SJ, Hegedüs L: Radioiodine therapy in
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single-subject case report. Disclosure Statement The author has no conflicts of interest to declare. Funding Sources No funding sources contributed to this research. References 1 Ross DS . Radioiodine therapy for
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.0597 ) 41 Hänscheid H Lassmann M Luster M Thomas SR Pacini F Ceccarelli C Ladenson PW Wahl RL Schlumberger M Ricard M Iodine biokinetics and dosimetry in radioiodine therapy of thyroid cancer: procedures and results of a prospective
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, Brazil
Department of Nuclear Medicine, Irmandade Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
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Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, Brazil
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Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, Brazil
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Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, Brazil
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dose and outcome of radioiodine therapy for thyroid cancer. N Engl J Med 1983;309:937-941. 10.1056/NEJM198310203091601 6621620 9 Hamburger JI, Desai P: Mannitol augmentation of 131 I uptake in the treatment of thyroid carcinoma. Metabolism 1966
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and nationwide surveys for thyroid storm. Clin Endocrinol 2016; 84: 912–918. 89 Bonnema SJ, Hegedus L: Radioiodine therapy in benign thyroid diseases: effects, side effects, and factors affecting therapeutic outcome. Endocr Rev 2012; 33: 920
FMTS, Faculté de Médecine, Université de Strasbourg, Strasbourg
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Inserm U1037, Université Paul Sabatier, Toulouse, France
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Background: Considerable variations in diagnosis and therapeutic practices are reported for hyperthyroidism (HT) between countries. Methods: A clinical study was conducted among a representative sample of 263 endocrinologists in France. All consecutive patients seen for HT during the study period were included. Diagnosis and treatment modalities were recorded from hyperthyroid patients with Graves disease (GD, n = 802), multinodular goiter (MNG, n = 121), and toxic adenoma (TA, n = 69). Results: Antithyroid antibodies were measured in half of the population (anti-TPO in 48.5% and anti-TSH receptor in 57.8%). Patients had thyroid ultrasonography and scintigraphy in 93.8 and 40.3%, respectively. Therapeutic management depended on the etiology: for the first episode of GD, antithyroid drugs (ATDs) were the first-line treatment in 91% of the patients, combined with surgery in 6.1% and with radioiodine in 2.9%. Surgery was preferred to radioiodine in MNG (52.6 vs. 22.4%) and TA (59.1 vs. 24.2%). Euthyroid status was achieved after 3 months in 64.4% of GD. A “block and replace” protocol was used in 41.2% of patients. After 3 months, 73% of patients were euthyroid in the “block and replace” group compared to 56.2% in the group with ATDs alone (p = 0.009). For MNG and TA, more than 75% of patients were euthyroid at the 3-month follow-up. Conclusions: Large discrepancies remain between clinical practice and international guidelines. These results should boost efforts to improve adherence to these guidelines.
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Objectives: Transaxillary robotic thyroidectomy surgery (TARS) has been reported to be a safe approach in patients with differentiated thyroid carcinoma, and oncological responses are promising. Study Design: This study aimed to evaluate the oncological outcomes of TARS followed by radioiodine (RAI) therapy in patients with differentiated thyroid carcinoma. Between 2011 and 2016, patients treated for differentiated thyroid carcinoma by TARS in a single institution, followed by RAI, were retrospectively included. The oncological response was performed according to the 2015 American Thyroid Association (ATA) guidelines 6–12 months later and at the last available visit. Results: A total of 42 patients (30 females) were included, with a median tumor size of 20 mm (12 cases of N1a and 5 cases of N1b on initial pathology report). According to ATA classification of recurrence risk after surgery, 17 and 25 patients were classified as low and intermediate risk, respectively. After RAI, all patients had a normal posttherapeutic whole body scan (except 1 patient, who had pathological lymph node uptake), but no unusual uptake was seen. At the 6- to 12-month evaluation (n = 37), 24 patients had excellent response, 8 had indeterminate response, and 5 had incomplete response (2 biological and 3 structural); no distant metastasis was found. At the last evaluation (median follow-up 15.9 months), 35 patients had no evidence of disease and 1 patient had a structural incomplete response. In total, a second open surgery was necessary for 3 patients to treat persistent lymph nodes (all intermediate risk). Conclusion: In this study, TARS followed by RAI therapy seems to be curative, even for patients with lymph node metastases, after good preoperative staging. More studies are required to confirm the findings.
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NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
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NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
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T, Takamura Y, Kobayashi K, Miya A, Miyauchi A: Excellent prognosis of patients with solitary T1N0M0 papillary thyroid carcinoma who underwent thyroidectomy and elective lymph node dissection without radioiodine therapy. World J Surg 2010
