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All Journal Jurnal Sain Veteriner Buletin Peternakan Althea Medical Journal Journal of Medicine and Health Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research Journal of Medicine and Health
Basuki Hidayat
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Veterinary Other

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Prevalence and Analysis of Risk Factors for RAI-Refractory Thyroid Cancer Patients: A 5-Year Retrospective Analysis from a Single Institution in Indonesia Putri, Syifa Azizah; Monty Priosodewo Soemitro; Basuki Hidayat; Kharisma Perdani Kusumahstuti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 11 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i11.1116

Abstract

Background: Radioactive iodine (RAI) therapy is a cornerstone in the management of differentiated thyroid cancer (DTC). However, a subset of patients develops RAI-refractory disease, characterized by the inability to concentrate radioiodine, leading to limited treatment options and a poorer prognosis. This study aimed to investigate the prevalence and identify potential risk factors associated with RAI-refractory DTC in an Indonesian population. Methods: A retrospective analysis was conducted on patients diagnosed with DTC and treated with RAI at a single tertiary care center in Indonesia between 2019 and 2023. Data on demographics, clinical characteristics, tumor features, and treatment outcomes were collected. RAI-refractoriness was defined as the absence of iodine uptake on diagnostic whole-body scans after cumulative RAI activity of 600 mCi or more. Bivariate and multivariate analyses were performed to identify risk factors for RAI-refractoriness. Results: A total of 194 patients with DTC were included in the study. The prevalence of RAI-refractoriness was 90%. The median age at diagnosis was 55 years (range 18-82), and 72% were female. Papillary thyroid carcinoma was the most common histological subtype (92%). In bivariate analysis, older age at diagnosis (p=0.02), male gender (p=0.04), and the presence of distant metastases at diagnosis (p<0.001) were significantly associated with RAI-refractoriness. In multivariate analysis, only the presence of distant metastases remained an independent predictor of RAI-refractoriness (odds ratio 3.8, 95% confidence interval 1.5-9.2, p=0.003). Conclusion: RAI-refractoriness is a significant clinical challenge in the management of DTC, with a high prevalence observed in this Indonesian cohort. The presence of distant metastases at diagnosis emerged as a strong predictor of RAI-refractoriness. Further research is needed to elucidate the underlying mechanisms of RAI-refractoriness and develop novel therapeutic strategies for this patient population.
Co-Authors Asmarani Kusumawati B. Sardjono Bethy Suryawathy Hernowo Christian Prijana Endah Indriani Endah Indriani Wahyono Febby Hutomo Hendra Budiawan Hendry Johan Renaldy Tandra Herry Herman Ivana D. Mulyanto Jessica Ubercaprita Joannes Sri Widada Johan S. Masjhur Kharisma Perdani Kusumahstuti Mas Adi Sunardi Monty Priosodewo Soemitro Putri, Syifa Azizah Ryan Yudistiro Yanti Mulyana