Research Article| Volume 116, ISSUE 6, P1024-1030, December 1994

Comparative analysis of complications from I-131 radioablation for well-differentiated thyroid cancer

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      Background. The decision to extend thyroidectomy to the opposite lobe during resection of well-differentiated thyroid cancer should include an analysis of complications of I-131 radioablation directly related to the thyroid remnant. If significant, then contralateral resection would be indicated. To clarify this issue we studied the incidence of complications of I-131 radioablation in 63 cases of well-differentiated thyroid cancer.
      Methods. Retrospective reviews of operative notes, pathology reports, office records, and physician interviews were made. We analyzed operations, complications, and radiation dosing.
      Results. Procedures included unilateral thyroidectomy, 10 (75.9%); subtotal thyroidectomy, seven (11.1%); near-total thyroidectomy, 25 (39.7%); and total thyroidectomy, 21 (33.3%). The average ablative dose was 101 mCi (range, 30 to 208 mCi). Nineteen percent (12 of 63) of patients had complications including radiation thyroiditis (eight), chronic sialoadenitis (one), odynophagia (one), facial edema (one), and shingles (one). Near-total or total' thyroidectomy resulted in significantly fewer complications compared with lesser resections (8:7% versus 47.1 %, p < 0.005).
      Conclusions. The incidence of complications of I-131 radioablation after thyroidectomy for well-differentiated thyroid cancer is related to the extent of thyroidectomy performed. We recommend contralateral thyroid resection (resulting in a near-total or total thyroidectomy) in patients likely to receive postoperative I-137 radioablation.
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        • Beirwaltes W.H.
        • Rabbani R.
        • Dmuchowski C.
        • Lloyd R.V.
        • Eyre P.
        • Mallette S.
        An analysis of “ablation of thyroid remnants” with 1–131 in 511 patients from 1947–1984: experience at University of Michigan.
        J Nucl Med. 1984; 25: 1287-1293
        • Clark O.H.
        Total thyroidectomy: the treatment of choice for patientswith differentiated thyroid cancer.
        Ann Surg. 1982; 196: 361-370
        • Mazzafarri E.L.
        • Young R.L.
        Papillary thyroid carcinoma: a 10 year follow-up report of the impact of therapy in 576 patients.
        Am J Med. 1981; 70: 511-518
        • Thompson N.W.
        • Nishiyama R.H.
        • Harness J.K.
        Thyroid carcinoma: current controversies.
        Curr Probl Surg. 1978; 15: 1-67
        • McHenry C.
        • Jarosz H.
        • Davis M.
        • Barbato A.L.
        • Lawrence A.M.
        • Paloyan E.
        Selective postoperative radioactive iodine treatment of thyroid carcinoma.
        Surgery. 1989; 106: 956-959
        • Rossi R.L.
        • Cady B.
        • Silverman M.L.
        • et al.
        Current results of conservative surgery for differentiated thyroid carcinoma.
        World J Surg. 1986; 10: 612-622
        • Cady B.
        • Rossi R.
        An expanded view of risk-group definition in differentiated thyroid carcinoma.
        Surgery. 1988; 104: 947-953
        • Hay I.D.
        • Grant C.S.
        • Taylor W.F.
        • McConahey W.M.
        Ipsilateral lobectomy versus bilateral lobar resection in papillary thyroid carcinoma: a retrospective analysis of surgical outcome using a novel prognostic scoring system.
        Surgery. 1987; 102: 1088-1094
        • Lee T.C.
        • Harbert J.C.
        • Dejter S.W.
        • Mariner D.R.
        • Van Dam J.
        Vocal cord paralysis following I-131 ablation of a postthyroidectomy remnant.
        J Nucl Med. 1985; 26: 49-50
        • Beierwaltes W.H.
        The treatment of thyroid carcinoma with radioactive iodine.
        Semin Nucl Med. 1978; 8: 79-94
        • Beierwaltes W.H.
        • Rabbani R.
        • Dmuchowski C.
        • Lloyd R.V.
        • Eyre P.
        • Mallette S.
        An analysis of “ablation of thyroid remnants” with I-131 in 511 patients from 1947–1984: experience at University of Michigan.
        J Nucl Med. 1984; 25: 1287-1293
        • Freitas J.E.
        • Gross M.D.
        • Ripley S.
        • Shapiro B.
        Diagnosis and therapy of thyroid cancer.
        Semin Nucl Med. 1985; 15: 106-631
        • Hurley J.R.
        • Becker D.V.
        Treatment of thyroid carcinoma with radioiodine.
        in: Gottschalk A. Hoffer P.B. Potchen E.J. Diagnostic nuclear medicine. 2nd ed. Williams and Wilkins, Baltimore1988: 799
        • Sisson J.C.
        Applying the radioactive eraser: 1–131 to ablate normal thyroid tissue in patients from whom thyroid cancer has been resected.
        J Nucl Med. 1983; 24 ([Editorial]): 743-745
        • Creutzig H.
        High or low dose radioiodine ablation of thyroid remnants?.
        Eur J Nucl Med. 1987; 12: 500-502
        • Hodge M.B.
        Role of thyroid-stimulating hormone suppression and radioactive iodine in differentiated carcinoma of the thyroid gland.
        in: Cady B. Rossi R.L. Surgery of the thyroid and parathyroid glands. 3rd ed. WB Saunders, Philadelphia1991: 223-232
        • Goolden A.W.G.
        • Kam K.C.
        • Fitzpatrick M.L.
        • Munro A.J.
        Oedema of the neck after ablation of the thyroid with radioactive iodine.
        Br J Radiol. 1986; 59: 583-586
        • Goolden A.W.G.
        The use of radioactive iodine in thyroid carcinoma.
        Eur J Cancer. 1988; 24: 339-343
        • Burmeister L.A.
        • duCret R.P.
        • Mariash C.N.
        Local reactions to radioiodine in the treatment of thyroid cancer.
        Am J Med. 1991;; 90: 217-222
        • Allweiss P.
        • Braunstein G.D.
        • Katz A.
        • Waxman A.
        Sialadenitis following 1–131 therapy for thyroid carcinoma: concise communication.
        J Nucl Med. 1984; 25: 755-758
        • Levenson D.
        • Gulec S.
        • Sonenberg M.
        • Lai E.
        • Goldsmith S.J.
        • Larson S.M.
        Peripheral facial nerve palsy after high-dose radioiodine therapy in patients with papillary thyroid carcinoma.
        Ann Intern Med. 1994; 120: 576-578
        • Maier H.
        • Bihl H.
        Effect of radioactive iodine therapy on parotid gland function.
        Acta Otolaryngol (Stockh). 1987; 103: 318-324
        • Bushnell D.L.
        • Boles M.A.
        • Kaufman G.E.
        • Wadas M.A.
        • Barnes W.E.
        Complications, sequela and dosimetry of iodine-131 therapy for thyroid carcinoma.
        J Nucl Med. 1992; 33: 2214-2220