Radioactive iodine therapy improves overall survival outcome in oncocytic carcinoma of the thyroid by reducing death risks from noncancer causes: A competing risk analysis of 4641 patients

Abstract Background Oncocytic carcinoma of the thyroid (OCA) is an independent type of thyroid cancer. Radioactive iodine (RAI) therapy was frequently administered to OCA patients, but its contribution to improving survival is indefinite. Methods 4641 OCA patients from 2000 to 2018 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Cox proportional hazard regression and competing risk analysis were applied. Results Tumor size, SEER stage, primary surgery, and neck dissection were prognostic factors for cancer‐specific survival. The results of competing risk analysis demonstrated that age over 55 years dramatically increased non‐OCA death risks. Treatments that improve non‐OCA survival (including total thyroidectomy, RAI therapy, and systemic therapy) should be recommended in OCA patients older than 55 years of age. Neck lymphadenectomy should not be recommended for OCA, since the metastatic lymph node ratio was low (about 3%). Conclusions RAI therapy can improve survival in OCA by reducing noncancer death risks.