Radioactive Iodine Therapy Does not Improve Cancer-specific Survival in Hürthle Cell Carcinoma of the Thyroid

Abstract Context It is unclear whether radioactive iodine (RAI) therapy could improve cancer-specific survival (CSS) in patients with Hürthle cell carcinoma (HCC) of the thyroid. Objective To investigate the effect of RAI on CSS in HCC patients. Methods HCC patients who underwent total thyroidectomy (TT) were identified from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2018. The Kaplan-Meier method and the Cox proportional hazards regression model were used to evaluate CSS. Propensity score–matched (PSM) analyses were performed to control the influence of potential confounders. Results A total of 2279 patients were identified. RAI treatment was not significantly associated with improved CSS in overall or PSM cohort. Subgroup analyses indicated similar results, even in patients with aggressive features such as age 55 years or older, tumor size greater than 40 mm, distant disease in SEER staging, extrathyroidal extension, and lymph node metastases (all P > .05). Conclusion RAI has no statistically significant influence on the CSS in HCC patients. This information may aid in decision-making for RAI therapy in these patients.