Selective Use of Radioiodine Therapy in Differentiated Thyroid Carcinoma: A Population-Based Cohort Study
Authors' conclusion
Excellent DSS can be achieved in DTC with selective use of adjuvant RAI, with the greatest benefit of RAI seen in those with metastatic DTC.
Study context
- Population
- Patients with differentiated thyroid cancer (DTC) operated on between 1970 and 2020; 783 males and 2547 females, mean age 48 years
- Participants
- 3,330 patients
- Exposure
- Radioactive iodine (RAI) therapy vs no RAI therapy
- Outcome
- Disease-specific survival (DSS) and disease-free survival (DFS)
Methodological detailspopulation-based, inverse probability of treatment weighting using propensity scores, competing risk secondary analyses
- Population-based
- Inverse probability of treatment weighting using propensity scores
- Competing risk secondary analyses
Main finding
As reported in the abstract
DSS
RAI vs non-RAIEstimate (CI)P value
Metastatic DTC; Cox proportional hazards model
HR 0.192(0.088–0.417)
P < 0.001Metastatic DTC; competing risk analysis
sub-hazard ratio 0.162(0.072–0.368)
P < 0.001- 10-year disease-specific survival (DSS) (whole cohort), median follow-up 14.1 years
- 97.2%
Observational data: associations, not effects.
Further findings
RAI use by risk category
- RAI administered, all cases
- 34.9%
- Low-risk
- 24.2%
- Intermediate-risk
- 31.1%
- High-risk
- 68.4%
Prognostic factors for DSS
- DSS adversely influenced by distant metastasis, incomplete resection, advanced age, male sex, non-papillary histology and advanced T stage
Original publication
Selective Use of Radioiodine Therapy in Differentiated Thyroid Carcinoma: A Population-Based Cohort Study. Thyroid. Published 18 January 2026. doi:10.
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