Modern approaches for the determination of radioiddiagnostics and radioid-therapy in a patient with promoted of thyroid papillary carcinoma

Abstract

The purpose is to analyze the dynamics of the prevalence among patients with papillary carcinoma with different characteristics and clinical parameters of the disease, as well as to  substantiate the expediency of assigning radioiodine diagnosis and radioiodine ablation in patients from different risk groups. Material and methods. Cohort of patients with papillary carcinomas, operated in 1995-2014 (4956 people) and patients who received radioiodine therapy in 2018 (98 people). Results. The frequency of papillary carcinoma with more aggressive characteristics (large size, presence of metastasis, intra-or extrathyroid invasion, multifocal) and more unfavorable course of disease (higher stage of disease and risk group, more number of courses of radioiodine therapy, poor prognosis for MACIS) among patients with cohort for 20 years of observation decreased. It was shown that in 71% of patients with papillary carcinoma of category pT1-pT2N0M0 in diagnostic scan there is no (or insignificant) accumulation of radiopharm drug. Conclusions. Radical removal of the thyroid gland with a tumor is a prerequisite for conducting patients with papillary carcinoma of very low and low risk only radioiodine diagnostics without further radioiodine ablation procedure. At the same time, taking into account Ukrainian realities, it is still not possible to completely refuse the use of ablation using 131I in patients in Ukraine who are part of the low-risk group, which is a modern trend in the world of thyroidology.