Second Primary Papillary Thyroid Carcinoma: Insights From Competing Risk Analysis and Post‐RAIT
Authors' conclusion
The survival prognosis for 2-PTC patients is generally favorable, and post-RAIT does not significantly affect mortality in intermediate-risk cases, indicating a need for reevaluation of its use.
Study context
- Population
- Patients with second primary papillary thyroid carcinoma (2-PTC), SEER-17 database 2004–2019; Cohort 2: intermediate-risk 2-PTCCohort 2: 1743
- Participants
- 6,399 patients
- Exposure
- Post-RAIT vs no postoperative radioactive iodine therapy (post-RAIT) in intermediate-risk 2-PTC
- Outcome
- Mortality risks (from 2-PTC, prior primary malignancies and other causes) with post-RAIT in intermediate-risk 2-PTC
Methodological detailsSEER-17 database, competing risk regression, propensity score matching, stabilized inverse probability treatment weighting with 500 bootstrap samples
- SEER-17 database
- Competing risk regression
- Propensity score matching
- Stabilized inverse probability treatment weighting with 500 bootstrap samples
Main finding
As reported in the abstract
Mortality risks in Cohort 2
- Post-RAIT did not significantly reduce mortality risks in Cohort 2
- No significant reduction even among patients aged ≥ 55 years, with clinical stage IV disease, or unfavorable prior primary malignancies (PPMs)
- Sensitivity analyses confirmed these findings
Observational data: associations, not effects.
Further findings
Most common PPMs (Cohort 1)
- Breast
- 25.5%
- Prostate
- 9.8%
- Skin cancer
- 6.7%
- Unfavorable PPMs
- 6.3%
Cumulative mortality by cause
- Lower cumulative mortality from 2-PTC than from PPMs and other causes
Demographics
- Predominantly older age, female sex, white ethnicity
Original publication
Second Primary Papillary Thyroid Carcinoma: Insights From Competing Risk Analysis and Post‐RAIT. Clin Endocrinol (Oxf). Published 7 September 2025. doi:10.
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