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Seo and Chung: Analysis of Therapeutic Modalities of Thyroid Cancer in Korea between 2008 and 2012
Original Article

Clin Exp Thyroidol 2014;7(2):167-171.

Published online: 2 November 2014

DOI: https://doi.org/10.11106/cet.2014.7.2.167

Analysis of Therapeutic Modalities of Thyroid Cancer in Korea between 2008 and 2012

Gi Hyeon Seo1, Jae Hoon Chung2

Health Insurance Review and Assessment Service, Seoul, Korea

Division of Endocrinology & Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Correspondence: Jae Hoon Chung, MD, PhD, Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea Tel: 82-2-3410-3434, Fax: 82-2-3410-3849, E-mail: thyroid@skku.edu

Received 10 July 2014       Accepted 2 October 2014

Copyright © 2014, the Korean Thyroid Association.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Backgrounds and Objectives

The incidence of thyroid cancer has been increasing in Korea as well as in other countries. The majority of thyroid cancers are papillary thyroid carcinomas and follicular thyroid carcinomas, both of which are classified as differentiated thyroid carcinoma (DTC). Total or near-total thyroidectomy followed by administration of radioactive iodine (RAI) constitutes the initial treatment for DTC. This study was conducted to investigate the therapeutic modalities of surgery and RAI for the treatment of DTC in Korea using claims data provided by the Health Insurance Review and Assessment Service.

Materials and Methods

This study was performed in 170,131 (men 29,002, women 141,129) Korean patients with thyroid cancer treated from January 2008 to December 2012. Patients with past history of thyroid cancer prior to 2008 were not included.

Results

Total or near total thyroidectomy was done in 83.4%, lobectomy in 14.4%, and subtotal thyroidectomy in 2.2%. Postoperative RAI treatment was performed in 52.7%. Median 100 mCi of RAI was administered at median 89 days after operation, and it was completed with one dose in 66.0%. Thirty mCi was mostly preferred as an initial dose in 35.6%, and subsequently 150 mCi in 25.7%, 100 mCi in 17.5%, and more than 150 mCi in 10.1%. Median cumulative RAI dose was 130 mCi. RAI treatment rate was decreasing during recent 5 years.

Conclusion

This is the first nationwide report to investigate the therapeutic modalities of surgery and RAI for the treatment of DTC in Korea.

Keywords: Thyroid cancer, Thyroidectomy, Radioactive iodine

References

1. Ministry of Health & Welfare. [cited Nov 9, 2014] http://www.mw.go.kr/front_newlindex.jsp.
2. American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL. et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009; 19(11):1167–214.
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4. Bilimoria KY, Bentrem DJ, Ko CY, Stewart AK, Winchester DP, Talamonti MS. et al. Extent of surgery affects survival for papillary thyroid cancer. Ann Surg. 2007; 246(3):375–81. discussion 81-4.
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Fig. 1.
Surgical extent of 170,131 patients with thyroid cancer who underwent thyroidectomy between 2008 and 2012.
jkta-7-167f1.tif
Fig. 2.
Rates of total thyroidectomy between 2008 and 2012.
jkta-7-167f2.tif
Fig. 3.
Comparison of first dose of radioactive iodine after thyroidectomy.
jkta-7-167f3.tif
Fig. 4.
Rates of radioactive iodine therapy which was done within 1 year after thyroidectomy between 2008 and 2012.
jkta-7-167f4.tif
Table 1.
Basal characteristics of 170,131 patients with thyroid cancer who underwent surgery between 2008 and 2012
Year Age (years)⋆ Women proportion⋆⋆ Number of operation
2008 47.7± 11.7 84.3% 25,445
2009 48.1±11.8 84.0% 30,589
2010 48.2± 11.7 82.9% 33,085
2011 48.3± 11.7 82.5% 38,314
2012 48.8± 11.8 81.9% 42,698
All (2008-2012) 48.3±11.8 83.0% 170,131

⋆ age (mean±SD)

⋆⋆ men 29,002 (17.0%) vs. women 141,129 (83.0%)

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