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Kahraman Çetin N, Taşan SC. Geriatric Importance of Histopathological Parameters Evaluated in Thyroidectomy Specimens: A Single Center Retrospective Analysis. J Pers Med 2024; 14:95. [PMID: 38248796 PMCID: PMC10817516 DOI: 10.3390/jpm14010095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/30/2023] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
Nowadays, the aging human population exerts a notable influence on the treatment of thyroid diseases. The most appropriate approach for the treatment of benign and malignant thyroid diseases in older adults has not yet been determined. The aim of our study is to evaluate the effect of thyroidectomies in geriatric patients considering age, sex and histopathological parameters and to determine the importance of thyroidectomy as a treatment option in the geriatric population. A total of 910 cases from all age groups were included, for which thyroidectomies were examined and reported. In accordance with the College of American Pathologists Cancer Protocol for thyroid reporting, considering geriatric patients, the rate of Thyroid Follicular Nodular Disease was significantly higher among the tumor types in the benign tumor group (p = 0.033), while Anaplastic Thyroid Carcinoma rate was higher in the malignant tumor group. The diagnosis rate of malignant tumors was higher in males, reflecting a more advanced pT stage (p < 0.001), larger tumor size (p < 0.001) and increased lymph node involvement rate (p = 0.039). Given that increasing age is associated with a heightened incidence of thyroid disease, the safety of surgery for geriatric patients is an important issue. Thyroidectomy should be considered in the treatment of these patients, especially in males, as the rate of malignant diagnosis and worse histopathological parameters are seen with increasing age.
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Affiliation(s)
- Nesibe Kahraman Çetin
- Department of Pathology, Faculty of Medicine, Aydın Adnan Menderes University, 09010 Aydın, Turkey;
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Díez JJ, Anda E, Alcazar V, Isidro ML, Familiar C, Paja M, Martín Rojas-Marcos P, Pérez-Corral B, Navarro E, Romero-Lluch AR, Oleaga A, Pamplona MJ, Fernández-García JC, Megía A, Manjón-Miguélez L, Sánchez-Ragnarsson C, Iglesias P, Sastre J. Consumption of health resources in older people with differentiated thyroid carcinoma: a multicenter analysis. Endocrine 2023; 81:521-531. [PMID: 37103683 DOI: 10.1007/s12020-023-03369-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 04/04/2023] [Indexed: 04/28/2023]
Abstract
OBJECTIVE There is hardly any information on the consumption of healthcare resources by older people with differentiated thyroid cancer (DTC). We analyzed these consumptions in older patients with DTC and compared patients 75 years and older with subjects aged 60-74 years. METHODS A multicenter, retrospective analysis was designed. We recorded three groups of health resources consumption (visits, diagnostic procedures, and therapeutic procedures) and identified a subgroup of patients with high consumption of resources. We compared patients aged between 60-74 years (group 1) with patients aged 75 and over (group 2). RESULTS We included 1654 patients (women, 74.4%), of whom 1388 (83.9%) belonged to group 1 and 266 (16.1%) to group 2. In group 2, we found a higher proportion of patients requiring emergency department visits (7.9 vs. 4.3%, P = 0.019) and imaging studies (24.1 vs. 17.3%; P = 0.012) compared to group 1. However, we did not find any significant difference between both groups in the consumption of other visits, diagnostic procedures, or therapeutic procedures. Overall, 340 patients (20.6%) were identified as high consumers of health resources, 270 (19.5%) in group 1 and 70 (26.3%) in group 2 (P = 0.013). Multivariate logistic regression analysis showed that the risk of recurrence and mortality, radioiodine treatment, tumor size, and vascular invasion were significantly related to the high global consumption of resources. However, the age was not significantly related to it. CONCLUSION In patients with DTC over 60 years of age, advanced age is not an independent determining factor in the consumption of health resources.
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Affiliation(s)
- Juan J Díez
- Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana, Majadahonda, Spain.
- Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
| | - Emma Anda
- Department of Endocrinology, Hospital Universitario de Navarra, Pamplona, Spain
| | - Victoria Alcazar
- Department of Endocrinology, Hospital Severo Ochoa, Leganés, Spain
| | - María L Isidro
- Department of Endocrinology, Complejo Hospitalario Universitario A Coruña, Coruña, Spain
| | - Cristina Familiar
- Department of Endocrinology, Hospital Clínico San Carlos, Madrid, Spain
| | - Miguel Paja
- Department of Endocrinology, Hospital Universitario de Basurto, Bilbao, Spain
- Department of Medicine, Universidad del País Vasco, Bilbao, Spain
| | | | - Begoña Pérez-Corral
- Department of Endocrinology, Complejo Asistencial Universitario de León, León, Spain
| | - Elena Navarro
- Department of Endocrinology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Ana R Romero-Lluch
- Department of Endocrinology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Amelia Oleaga
- Department of Endocrinology, Hospital Universitario de Basurto, Bilbao, Spain
- Department of Medicine, Universidad del País Vasco, Bilbao, Spain
| | - María J Pamplona
- Department of Endocrinology, Hospital Royo Villanova, Zaragoza, Spain
| | - José C Fernández-García
- Department of Endocrinology, Hospital Regional Universitario de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain
| | - Ana Megía
- Department of Endocrinology, Hospital Universitario de Tarragona Joan XXIII, IISPV, Universitat Rovira i Virgili, Ciberdem, Tarragona, Spain
| | - Laura Manjón-Miguélez
- Department of Endocrinology, Hospital Universitario Central de Asturias & Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Cecilia Sánchez-Ragnarsson
- Department of Endocrinology, Hospital Universitario Central de Asturias & Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Pedro Iglesias
- Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana, Majadahonda, Spain
- Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - Julia Sastre
- Department of Endocrinology, Complejo Hospitalario de Toledo, Toledo, Spain
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Mishra T, Mohapatra I, Srivastava V, Rout TK. Assessment of Post-operative Complications in Patients Undergoing Thyroid Surgery in a Tertiary Care Hospital in Eastern India. Cureus 2023; 15:e42549. [PMID: 37637525 PMCID: PMC10460142 DOI: 10.7759/cureus.42549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 08/29/2023] Open
Abstract
Background Thyroid surgeries, among the most common surgical procedures globally, present with varied complications. This study is aimed at identifying the complications and selected variables associated with thyroid surgery. Methods In this cross-sectional, retrospective, record-based study, a total of 107 patients who underwent thyroidectomies and satisfied the inclusion criteria, were recruited using convenience sampling technique. This study was conducted at a tertiary care hospital from January 2021 to December 2021. Data were collected from medical records using a researcher-created data extraction form after ethical approval from the institutional ethics committee. The data were analyzed using Epi Info software (Atlanta, GA: Centers for Disease Control and Prevention), with a p-value of <0.05 considered to be statistically significant. Results Of the 107 patients who underwent thyroidectomies, 92 (85.9%) reported one or more complications. Complications were most common (90.2% of patients) in the 25-34 years age group and among females (83.3%). The most common complications were dysphagia (30.84% of patients), voice change (21.50%), and respiratory obstruction (8.41%). Temporary hypocalcemia developed in 3.74% of these patients, while tracheal injury and hematoma were documented in 3.74% and 1.87%, respectively. Tobacco users (14.9%), alcohol users (16.8%), those eating a non-vegetarian diet (61.9%), and those eating saturated fats (13.0%) suffered more complications. Family history (p=0.03) was found to be significantly associated with complications. Conclusion The most common post-thyroidectomy complications in this group of patients were dysphagia and voice change, while hypocalcemia, tracheal injury, and hematoma were rare complications. Tobacco users and alcohol users reported more complications. Complications were more common in those with a family history of thyroid disease and those who were underweight.
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Affiliation(s)
- Tejaswi Mishra
- Department of General Surgery, Maharaja Krushna Chandra Gajapati (MKCG) Medical College, Berhampur, IND
| | - Ipsa Mohapatra
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, IND
| | - Varsha Srivastava
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, IND
| | - Tapas K Rout
- Department of General Surgery, Maharaja Krushna Chandra Gajapati (MKCG) Medical College, Berhampur, IND
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Van den Eynde F, Van Den Heede K, Brusselaers N, Van Slycke S. Thyroid surgery in the elderly: a surgical cohort. Langenbecks Arch Surg 2023; 408:254. [PMID: 37386199 DOI: 10.1007/s00423-023-02982-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 06/13/2023] [Indexed: 07/01/2023]
Abstract
PURPOSE The need for thyroid surgery in the elderly is rising due to an ageing population, the liberal use of imaging studies, and the increasing prevalence of thyroid nodules and cancer with age. Data on surgical outcomes in this population are scarce and conflicting, but essential to assess safety of short-stay surgery. This study aims to compare surgical outcomes by age. METHODS All consecutive patients undergoing thyroid surgery from January 2010 to July 2021 in a large tertiary referral centre for endocrine surgery were included in this surgical cohort. The indication for surgery, surgical morbidity (hypocalcaemia, bleeding, recurrent laryngeal nerve (RLN) palsy), and length of hospital stay were assessed in three age groups (young: 18-64y, older: 65-74y, and the elderly: 75 years and older). RESULTS A total of 2,030 patients (1,499 young, 370 older, and 161 elderly) were included. The indication for surgery was significantly different, with the main indications in the elderly being multinodular goitre (70.2% vs. 47.7% in young patients) and thyroid cancer (9.9% vs. 7.0%). Reintervention for bleeding was more often required in the older (4.6%) and the elderly (2.5%) patients (vs. 1.4%). There was no difference in the proportion of hypocalcaemia or RLN palsy. The length of hospital stay was significantly longer in the elderly (length of stay longer than one day 43.5% vs. 9.8%). CONCLUSION Thyroid surgery in patients aged 75 years and older is a safe procedure with morbidity comparable to younger patients. However, the risk of reintervention for bleeding is higher, rendering ambulatory surgery not advisable. TRIAL REGISTRATION Researchregistry6182 on October 29th 2020, retrospectively registered.
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Affiliation(s)
- Fien Van den Eynde
- Group of Biomedical Sciences, University Hospital Leuven, Herestraat 49, 3000, Louvain, Belgium.
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Hospital Aalst, Moorselbaan 164, 9300, Aalst, Belgium.
| | - Klaas Van Den Heede
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Hospital Aalst, Moorselbaan 164, 9300, Aalst, Belgium
| | - Nele Brusselaers
- Centre for Translational Microbiome Research Department of Microbiology, Tumour and Cell Biology, Karolinska Institute, Tomtebodavagen 16, 17165, Stockholm, Sweden
- Global Health Institute, University of Antwerp, Doornstraat 331, 2610, Wilrijk, Belgium
- Department of Head and Skin, University Hospital Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Sam Van Slycke
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Hospital Aalst, Moorselbaan 164, 9300, Aalst, Belgium
- Department of Head and Skin, University Hospital Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium
- Department of General Surgery, AZ Damiaan, Gouwelozestraat 100, 8400, Ostend, Belgium
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Farhad SA, Anders B, Erik N, Martin N, Martin A. Mortality after benign thyroid surgery in patients aged 80 years or older. Langenbecks Arch Surg 2022; 407:1659-1665. [PMID: 35286467 PMCID: PMC9283352 DOI: 10.1007/s00423-022-02463-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/07/2022] [Indexed: 11/22/2022]
Abstract
Introduction A recent report from the United Nations showed that aged people are increasing worldwide. Few data exist on overall survival for patients 80 years or older undergoing benign thyroid surgery. Short- and long-term survival and risk factors for death in patients undergoing thyroid surgery for benign disease were evaluated, using a nationwide, population-based quality register. Methods Patients operated for benign thyroid disease, 2004 to 2017, were collected from the national quality register for thyroid surgery. Mortality data were retrieved from the Swedish National Board of Health and Welfare. Mortality at 30 days, 90 days, and 1 year after surgery, for patients 80 years or older, was calculated. Overall survival was calculated using the Kaplan–Meier estimate. Risk factors for mortality were assessed with Cox’s multiple regression analysis. The standardized mortality ratio was calculated. Results There were 17,969 patients. Among them, 483 patients were 80 years or older, and of these, 397 (82.2%) were women. The mortality rate at 0–30 days, 31–90 days, and at 91–365 days after surgery was 0.4%, 0.2%, and 2.5%, respectively. The median (IQR) follow-up time was 4.5 (2.9–7.2) and the median (IQR) survival time was 8.0 (4.1–12.5) years. Apart from age, there was no other risk factor for death. The standardized mortality ratio (SMR) was 0.67 (0.49–0.91) for men and 0.76 (0.65–0.89) for women. Conclusion Mortality after surgery for benign thyroid disease in patients 80 years or older was lower than the general population with no specific risk factors for death except for age.
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Alqahtani SM, Alatawi AS, Alalawi YS. Post-Thyroidectomy Hypocalcemia: A Single-Center Experience. Cureus 2021; 13:e20006. [PMID: 34987897 PMCID: PMC8716130 DOI: 10.7759/cureus.20006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2021] [Indexed: 12/04/2022] Open
Abstract
Introduction Thyroidectomy is a frequent operation performed worldwide. The most common complication following thyroid surgery is hypocalcemia, caused by transient or persistent hypoparathyroidism. This study aimed to investigate the prevalence of hypocalcemia after thyroidectomy and to identify potential risk factors. Methods All thyroidectomies performed at a single tertiary center between 2012 and 2017 were retrospectively analyzed. Post-thyroidectomy hypocalcemia was evaluated in relation to risk factors such as age, sex, procedure type, and type of thyroid disease. Data were extracted from patient medical records. Patients with pre-operative hypocalcemia were excluded. Results We enrolled 182 patients who underwent thyroidectomy. Female patients comprised 83% (n = 151) of the total patients. Of all patients, 116 (63.7%) had developed post-operative temporary hypocalcemia and three (1.6%) had persistent hypocalcemia. Remarkably, no cases of mortality were reported. There was no significant relationship between the occurrence of hypocalcemia and age, type of thyroid disease, and sex. Conversely, there was a significant relationship between the development of hypocalcemia and the type of procedure (P < 0.001). Conclusion Thyroidectomy is a safe surgery with few complications when performed by a skilled surgeon. These complications result in longer hospital stays and higher costs. The most common post-thyroidectomy complication was hypocalcemia. Furthermore, patients who underwent total thyroidectomy were at the greatest risk of developing post-thyroidectomy hypocalcemia.
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Alqahtani SM, Almussallam B, Alatawi AS, Alsuhaimi NA, Albalawi A, Albalawi NS, Alzahrani AM, Alalawi Y. Post-Thyroidectomy Complications and Risk Factors in Tabuk, Saudi Arabia: A Retrospective Cohort Study. Cureus 2020; 12:e10852. [PMID: 33178506 PMCID: PMC7652027 DOI: 10.7759/cureus.10852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Thyroid surgery is one of the most commonly performed procedures internationally. There were no studies conducted in Tabuk, Saudi Arabia, on post-thyroidectomy complications and their risk factors. Objective The aim of this study was to assess post-thyroidectomy complications and determine the risk factors of such complications. Methods This retrospective study included all cases that underwent thyroidectomy at King Salman Armed Forces Hospital, Tabuk, Saudi Arabia, from January 2012 to December 2017. Patients with preoperative hypoparathyroidism, chronic kidney disease, or history of dysphonia were excluded. Data were collected from medical records. Results The study showed 182 patients who underwent thyroidectomy operation between January 2012 and December 2017. Temporary hypocalcemia was developed in 116 patients (63.7%) while it persisted in three (1.6%). Change of voice was reported in five patients (2.7%) while two (1.1%) lost a high-pitched voice. Seroma, hematoma, and tracheal injury were documented in 1.6%, 1.1%, and 0.5%, respectively. Multivariate analysis showed that total thyroidectomy was the most significant (four times) risk factor for the development of hypocalcemia as compared to other surgical procedures. Conclusion Hypocalcemia was the most frequent post-thyroidectomy complication, whereas voice changes, seroma, hematoma, and tracheal injury are rare complications. Additionally, total thyroidectomy has the highest risk of postoperative hypocalcemia.
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Affiliation(s)
- Saad M Alqahtani
- Department of Surgery, College of Medicine, Majmaah University, Majmaah, SAU
| | - Basem Almussallam
- Department of Surgery, College of Medicine, Majmaah University, Majmaah, SAU.,Department of Surgery, McMaster University, Hamilton, CAN
| | | | - Nada Awad Alsuhaimi
- Department of Family Medicine, King Salman Armed Forces Hospital in North-Western Region, Tabuk, SAU
| | - Amani Albalawi
- Department of Radiology, King Fahad Medical City, Riyadh, SAU
| | | | - Attiya M Alzahrani
- Department of Surgery, King Salman Armed Forces Hospital in North-Western Region, Tabuk, SAU
| | - Yousef Alalawi
- Department of Surgery, King Salman Armed Forces Hospital in North-Western Region, Tabuk, SAU
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Saadi R, Brandt A, Kim Y, Cottrill E, Saunders B, Schaefer E, Goldenberg D. Degree of technical difficulty of thyroidectomy for autoimmune thyroid disease. Head Neck 2019; 42:262-268. [PMID: 31651072 DOI: 10.1002/hed.25991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/16/2019] [Accepted: 10/09/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Our goal was to elucidate the differences in degree of technical difficulty of thyroidectomy in patients with autoimmune thyroid diseases. METHODS Charts of adult patients who had undergone thyroidectomy were reviewed. Patients with Hashimoto's Thyroiditis (HT) or Graves' Disease (GD) were individually compared to a control group of patients with early stage malignancy or goiter. RESULTS The HT (n = 65) group was significantly more likely to have friable (P = .001) and fibrotic (P < .001) thyroids, longer operative times (P = .02), and a 22-modifier (P = .005). The GD (n = 169) group was significantly more likely to have friable (P < .001), vascular (P < .001), fibrotic (P = .038), and heavy (P = .002) thyroids, longer operative times (P = .03), increased length of stay (P = .01) and a 22-modifier (P = .01). CONCLUSION Our experience at an institution with a high-volume thyroid practice demonstrates that patients with autoimmune thyroid disease have consistent qualitative changes of the thyroid and significantly increased operative times and surgical difficulty.
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Affiliation(s)
- Robert Saadi
- Department of Otolaryngology - Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
| | - Alyssa Brandt
- College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania
| | - Yesul Kim
- Department of Dermatology, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
| | - Elizabeth Cottrill
- Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Brian Saunders
- Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
| | - Eric Schaefer
- Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
| | - David Goldenberg
- Department of Otolaryngology - Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
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Duskin-Bitan H, Leibner A, Amitai O, Diker-Cohen T, Hirsch D, Benbassat C, Shimon I, Robenshtok E. Bone-Marrow Suppression in Elderly Patients Following Empiric Radioiodine Therapy: Real-Life Data. Thyroid 2019; 29:683-691. [PMID: 31084551 DOI: 10.1089/thy.2018.0423] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Elderly patients with differentiated thyroid cancer (DTC) tend to have more advanced disease at presentation, for which high activities of radioiodine (RAI) are often recommended. However, the 2015 American Thyroid Association guidelines recommend that empirically administered activities of RAI >150 mCi should be avoided in patients >70 years of age, based on calculated bone-marrow exposure according to two dosimetry-based studies. This study aimed to evaluate the effect of RAI treatment on bone-marrow function in elderly DTC patients. Methods: DTC patients ≥70 years of age who received RAI treatment and on whom a complete blood count was performed before and after treatment were included. Blood counts within one year before RAI and one year following treatment were compared in order to assess for marrow suppression. The impact of demographic, clinical, and laboratory variables on complete blood count were assessed. Results: One hundred fifty-three treatments in 122 patients met inclusion criteria, with a mean patient age of 76 ± 4.3 years, and 75% were women. High-risk features at presentation included T4 disease in 17%, lymph node metastases in 34%, and distant metastases in 14%. Mean RAI activity was 136.8 ± 48 mCi (82% ≥ 100 mCi, 66% ≥ 150 mCi). Of 153 RAI treatments analyzed, 114 (74%) were first treatments, 28 (18%) second treatments, seven (5%) third treatments, and four (3%) fourth treatments. At 0-3 months after RAI treatment, there was a statistically significant decrease in platelets (238 ± 66 vs. 216 ± 69 × 109/L, 10% decrease; p < 0.001), white blood cells (WBC; 6.9 ± 2 vs. 6.1 ± 1.9 × 109/L, 13% decrease; p < 0.001), and hemoglobin (Hb) in women (12.8 ± 1.1 vs. 12.4 ± 1.1 g/dL, 3% decrease; p = 0.01). Mean platelets, WBC, Hb in women, and lymphocytes remained decreased (but within the reference range) one year after treatment. Subgroup analysis demonstrated platelet suppression only with activities ≥100 mCi, and WBC and Hb suppression only with activities ≥150 mCi, with mean values within the reference ranges. There were no clinically significant cytopenia events during follow-up. Conclusions: Empiric RAI treatment in elderly patients causes mild bone-marrow suppression, with little clinical significance. Activities of 150-200 mCi can be safely used when indicated.
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Affiliation(s)
- Hadar Duskin-Bitan
- 1 Endocrinology Institute, Rabin Medical Center, Petah-Tikva, Israel
- 2 Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
| | - Anat Leibner
- 1 Endocrinology Institute, Rabin Medical Center, Petah-Tikva, Israel
- 2 Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
| | - Oren Amitai
- 1 Endocrinology Institute, Rabin Medical Center, Petah-Tikva, Israel
- 2 Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
| | - Talia Diker-Cohen
- 1 Endocrinology Institute, Rabin Medical Center, Petah-Tikva, Israel
- 2 Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
| | - Dania Hirsch
- 1 Endocrinology Institute, Rabin Medical Center, Petah-Tikva, Israel
- 2 Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
| | - Carlos Benbassat
- 2 Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
- 3 Endocrine Institute, Assaf Harofeh Medical Center, Zrifin, Israel
| | - Ilan Shimon
- 1 Endocrinology Institute, Rabin Medical Center, Petah-Tikva, Israel
- 2 Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
| | - Eyal Robenshtok
- 1 Endocrinology Institute, Rabin Medical Center, Petah-Tikva, Israel
- 2 Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
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