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Purpose <p>Postoperative radioiodine (RAI) treatment is commonly used for remnant ablation in differentiated thyroid cancer (DTC). However, the clinical efficacy of RAI therapy in low-risk patients remains controversial. This systematic review and meta-analysis evaluate the effectiveness of postoperative RAI in reducing recurrence in low-risk DTC.</p> Methods <p>We searched PubMed, Embase, and Cochrane Central for randomized controlled trials and observational studies comparing low-risk DTC patients who underwent thyroidectomy or lobectomy, and received either RAI ablation or not. We evaluated structural recurrence, recurrence rate, and recurrence-free survival. A risk ratio (RR) with 95% confidence intervals (CI) was computed for binary endpoints. All statistical analyses were performed using R (version 4.4.1).</p> Results <p>Eight studies with 6,411 postoperative low-risk DTC patients were analyzed, of whom 4019 (62.6%) were administered RAI. Structural recurrences were numerically lower in the RAI group; however, this difference was not statistically significant, as the 95% confidence interval crossed the null value (RR 0.64; 95% CI 0.34–1.18; I² = 33%). RAI did not significantly reduce the recurrence rate (RR 0.86; 95% CI 0.46–1.63; I² = 47%). The recurrence-free survival outcome was comparable between RAI ablation and no RAI after surgery (RR 1.00; 95% CI 0.97–1.03; I² = 85%).</p> Conclusion <p>This meta-analysis found no statistically significant difference in recurrence rate, recurrence-free survival, or structural recurrence between radioiodine ablation and no radioiodine ablation in patients with low-risk DTC post-thyroidectomy or lobectomy. In meta-regression, we found an association of follicular thyroid cancer with low recurrence-free survival rates and higher structural recurrence rates, suggesting that it may require a different approach.</p>

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Postoperative radioiodine versus no radioiodine therapy for patients with low-risk differentiated thyroid cancer: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2026年2月9日

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  • Assaina T. J. Tomo,
  • Lívian de Sousa Gonçalves,
  • Piyush Ratan,
  • Gabriela Gazzoni,
  • Ana Carolina Ventura de Santana de Jesus,
  • Tatiana Carvalho Marques,
  • Maria E. C. Souza,
  • Rafaela Correia Maciel,
  • Felipe Mourato

摘要

Purpose

Postoperative radioiodine (RAI) treatment is commonly used for remnant ablation in differentiated thyroid cancer (DTC). However, the clinical efficacy of RAI therapy in low-risk patients remains controversial. This systematic review and meta-analysis evaluate the effectiveness of postoperative RAI in reducing recurrence in low-risk DTC.

Methods

We searched PubMed, Embase, and Cochrane Central for randomized controlled trials and observational studies comparing low-risk DTC patients who underwent thyroidectomy or lobectomy, and received either RAI ablation or not. We evaluated structural recurrence, recurrence rate, and recurrence-free survival. A risk ratio (RR) with 95% confidence intervals (CI) was computed for binary endpoints. All statistical analyses were performed using R (version 4.4.1).

Results

Eight studies with 6,411 postoperative low-risk DTC patients were analyzed, of whom 4019 (62.6%) were administered RAI. Structural recurrences were numerically lower in the RAI group; however, this difference was not statistically significant, as the 95% confidence interval crossed the null value (RR 0.64; 95% CI 0.34–1.18; I² = 33%). RAI did not significantly reduce the recurrence rate (RR 0.86; 95% CI 0.46–1.63; I² = 47%). The recurrence-free survival outcome was comparable between RAI ablation and no RAI after surgery (RR 1.00; 95% CI 0.97–1.03; I² = 85%).

Conclusion

This meta-analysis found no statistically significant difference in recurrence rate, recurrence-free survival, or structural recurrence between radioiodine ablation and no radioiodine ablation in patients with low-risk DTC post-thyroidectomy or lobectomy. In meta-regression, we found an association of follicular thyroid cancer with low recurrence-free survival rates and higher structural recurrence rates, suggesting that it may require a different approach.