Brisy question: What % of pts will have radionucleotide uptake after a "total-thyroidectomy"?
Debate remains surrounding the need for radioablation after total thyroidectomy for papillary thyroid ca.
Hay argues that there is no need for radioablation:
- retrospective study from 1940's to present where there has been increased frequency of radioablation has not correlated into increased survival or decreased tumor recurrence.
Mazzaferri argues that radioablation should be performed:
- large remnant can obscure I-131 uptake in cervical or lung mets
- Found that in pts with tumors >1.5cm - cancer recurrence, distant recurrence and cancer death rates were lower after remnant ablation
- They conceed that not everyone has found this and believe that perhaps groups such as Hay had more aggressive total thyroidectomies that left less remnant tissue
Complications associated with I-131 radioablation:
Acute:
Chronic:
No comments:
Post a Comment