TSH Stimulation Methods are Associated with Comparable Outcomes in Radioiodine-Avid Metastatic Differentiated Thyroid Cancer: Single Center Retrospective Observational Study
Authors' conclusion
In radioiodine-avid metastatic DTC, rhTSH or mixed rhTSH/THW preparation is associated with comparable adjusted outcomes. Prognosis appears to be chiefly driven by metastatic burden and age.
Study context
- Population
- Consecutive patients with radioiodine-avid distantly metastatic differentiated thyroid carcinoma (DTC) initiating RAI therapy 2005–2015, single centre; Thyroid hormone withdrawal (THW)-only patients excludedconsecutive eligible · THW-only patients 5
- Participants
- 189 patients
- Exposure
- Recombinant human TSH (rhTSH) only vs mixed stimulation before RAI therapy
- rhTSH onlyn = 81
- Mixed stimulationn = 108reference
- Outcome
- TTP and OS by TSH stimulation method
- Follow-up
- Median 123 (3-182) months
Methodological detailssingle-centre, propensity score matching
- Single-centre
- Propensity score matching
Main finding
As reported in the abstract
median follow-up 123 (3-182) months
- After adjustment, TSH stimulation method was not independently associated with time-to-progression (TTP) or overall survival (OS)
- Strongest independent predictors: metastatic burden (macrometastasis) and age at DTC diagnosis
- Propensity score-matched cohort: no significant differences in TTP or OS between stimulation groups
- Mixed stimulation vs rhTSH only: P < 0.05
- Mixed stimulation vs rhTSH only: P < 0.01
- Unadjusted log-rank; multivariable Cox
Observational data: associations, not effects.
Further findings
Best radiologic response (all patients)
- Stable disease
- 49%
- Complete response
- 23%
- Partial response
- 18%
- Progressive disease
- 10%
- No significant differences between TSH stimulation subgroups
Original publication
TSH Stimulation Methods are Associated with Comparable Outcomes in Radioiodine-Avid Metastatic Differentiated Thyroid Cancer: Single Center Retrospective Observational Study. Thyroid. Published 14 May 2026. doi:10.
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