• Pol. Arch. Med. Wewn. · Jan 2025

    Comparison of models predicting efficacy of radioiodine therapy in patients with differentiated thyroid cancer.

    • Martyna Borowczyk, Elżbieta Jodłowska-Siewert, Dorota Filipowicz, Paweł Komarnicki, Frederik A Verburg, Katarzyna Ziemnicka, Ewelina Szczepanek-Parulska, and Marek Ruchała.
    • Pol. Arch. Med. Wewn. 2025 Jan 7.

    IntroductionDifferentiated thyroid cancer (DTC) is the most common type of endocrine malignancy, with rising incidence over recent decades. Despite a favorable prognosis, DTC management remains complex, often involving thyroidectomy followed by radioactive iodine (RAI) therapy. While RAI is crucial for patient outcomes, its efficacy varies, necessitating the identification of predictors for treatment response.ObjectivesWe aimed to evaluate predictive models for RAI therapy efficacy in DTC patients treated with thyroidectomy and RAI remnant ablation and to determine thyroid biomarker cut-off values.Patients And MethodsWe conducted a retrospective analysis of 744 DTC patients treated at a single center, focusing on clinicopathological factors and thyroid biomarkers. Multivariable logistic regression models were constructed to evaluate the predictive value of different DTC biomarkers, adjusting for covariates such as age, sex, and disease stage. Cut-off values for these biomarkers were determined to predict RAI efficacy.ResultsThe study revealed no significant difference in predictive performance among models incorporating various DTC biomarkers. Stimulated thyroglobulin (sTg) emerged as a reliable predictor, with a mean cut-off value of 7.22 ng/mL. Kaplan-Meier curves confirmed its role as treatment-free survival predictor. Additionally, chronic lymphocytic thyroiditis (CLT) status tended to enhance predictive accuracy, although not significantly.ConclusionsOur study underscores the utility of sTg as a single parameter for predicting RAI efficacy in DTC patients, with a defined cut-off value facilitating clinical decision-making. The inclusion of CLT status may further enhance predictive models. There is a need to advance personalized management approaches for DTC patients undergoing RAI therapy.

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