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Cited by 82Multiple and Secondary Primary CancersThyroid Cancer Diagnosis and TreatmentThyroid and Parathyroid Surgery

Risk of second primary malignancy in differentiated thyroid carcinoma treated with radioactive iodine therapy

Lang, Brian Hung-Hin, Wong, Irene Oi Ling, Wong, Kai Pun, Cowling, Benjamin J., Wan, Koon-Yat·2012·Surgery
DOI 10.1016/j.surg.2011.12.019
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Abstract

Background Differentiated thyroid cancer survivors are at increased risk of nonsynchronous second primary malignancy, but the cause remains unclear. This study aimed to evaluate the association between radioiodine therapy and risk of nonsynchronous second primary malignancy and to examine whether the risk of nonsynchronous second primary malignancy in differentiated thyroid cancer survivors treated with radioiodine therapy is increased relative to the general population.Methods Among 895 radiation-naïve patients with differentiated thyroid cancer, 643 (71.8%) received ≥1 course of radioiodine therapy (radioiodine therapy-positive group) and 252 (28.2%) received no radioiodine therapy (radioiodine therapy-negative group). After a median follow-up of 93.5 months (range, 23.4-570.8), 64 (7.2%) patients developed ≥1 nonsynchronous second primary malignancy. Potential risk factors for nonsynchronous second primary malignancy were entered into a multivariable regression model and cancer incidence in the radioiodine therapy-positive and -negative groups were compared to that of the general population by estimating the standardized incidence ratios.Results The 20-year cumulative nonsynchronous second primary malignancy risk in radioiodine therapy-positive group was significantly higher than radioiodine therapy-negative group (13.5% vs 3.1%; P = .015). Cumulative radioiodine therapy activity of 3.0 to 8.9 GBq (relative risk, 2.77; 95% CI, 1.079-7.154; P = .034) was the only independent risk factor for nonsynchronous second primary malignancy after adjusting for age, sex, period of differentiated thyroid cancer diagnosis, and stage of differentiated thyroid cancer. For females, the standardized incidence ratio in the radioiodine therapy-positive group was 1.54 (95% CI, 1.11-2.08) and in the radioiodine therapy-negative group it was 0.92 (95% CI, 0.37-1.90).Conclusion Differentiated thyroid cancer female survivors treated by radioiodine therapy appeared to be at elevated risk of nonsynchronous second primary malignancy when compared to the general population and this risk was not apparent in those not previously treated by radioiodine therapy.

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Crossref · 10.1016/j.surg.2011.12.019

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  • Except for the study performed by Lang et al., all studies reported an increased risk of occurrence of both solid tumors and leukemia after treatment with 131I.

    “Except for the study performed by Lang et al. ( 97 ), all studies reported an increased risk of the occurrence of both solid tumors and leukemia after treatment with 131 I.”

    From Normal-Tissue Tolerance to Radiopharmaceutical Therapies, the Knowns and the Unknowns (2021) · cites this paper as [97]

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Authors
Lang, B. H.-H., Wong, I. O. L., Wong, K. P., Cowling, B. J., & Wan, K.-Y.
Affiliations
University of Hong Kong (HK)
Corresponding author
Lang, Brian Hung-Hin
ORCID
Venue
Surgery
Publisher
Elsevier BV
Published
2012-06
Volume
151
Issue
6
Pages
844-850
ISSN
0039-6060 (ISSN-L)
DOI
10.1016/j.surg.2011.12.019
OpenAlex
W2001004136
Cited by
82
References
22
Citations by year
2026: 1 · 2025: 3 · 2024: 3 · 2023: 6 · 2022: 9 · 2021: 5 · 2020: 4 · 2019: 2 · 2018: 7 · 2017: 7 · 2016: 5 · 2015: 14 · 2014: 6 · 2013: 4 · 2012: 5
FWCI
6.94
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Surgery (publishedVersion)
  • PubMed (publishedVersion)
  • The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Multiple and Secondary Primary Cancers
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords
second primary malignancy, differentiated thyroid cancer, radioiodine therapy, cancer survivors, radiation-induced cancer risk, sex differences, standardized incidence ratio
MeSH terms
Thyroid Cancer, Papillary, Adolescent, Adult, Aged, Aged, 80 and over, Carcinoma, Carcinoma, Papillary, Child, Female, Follow-Up Studies, Humans, Iodine Radioisotopes, Longitudinal Studies, Male, Middle Aged, Neoplasm Staging, Retrospective Studies, Risk Factors, Thyroid Neoplasms, Incidence, Multivariate Analysis, Neoplasms, Second Primary, Adenocarcinoma, Follicular, Young Adult

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