Second primary malignancy risk in thyroid cancer and matched patients with and without radioiodine therapy analysis from the observational health data sciences and informatics.

YoungHwan Joo, Ho-Young Lee, Sooyoung Yoo, Dongyoon Yang, Yangha Chung, Byungwon Kim, Woncheol Jang, Jung Mi Park, Jin Chul Paeng, Hyun Gee Ryoo, Seok Kim, Junmo Kim, Kwangsoo Kim, Ie Ryung Yoo, SooJeong Ko, In Young Choi, Borham Kim, Dachung Boo, Ji-In Bang

Journal: European journal of nuclear medicine and molecular imaging 2022;49(10):3547-3556

PMID: 35362796

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Abstract

PURPOSE

Risk of second primary malignancy (SPM) after radioiodine (RAI) therapy has been continuously debated. The aim of this study is to identify the risk of SPM in thyroid cancer (TC) patients with RAI compared with TC patients without RAI from matched cohort.

METHODS

Retrospective propensity-matched cohorts were constructed across 4 hospitals in South Korea via the Observational Health Data Science and Informatics (OHDSI), and electrical health records were converted to data of common data model. TC patients who received RAI therapy constituted the target group, whereas TC patients without RAI therapy constituted the comparative group with 1:1 propensity score matching. Hazard ratio (HR) by Cox proportional hazard model was used to estimate the risk of SPM, and meta-analysis was performed to pool the HRs.

RESULTS

Among a total of 24,318 patients, 5,374 patients from each group were analyzed (mean age 48.9 and 49.2, women 79.4% and 79.5% for target and comparative group, respectively). All hazard ratios of SPM in TC patients with RAI therapy were ≤ 1 based on 95% confidence interval(CI) from full or subgroup analyses according to thyroid cancer stage, time-at-risk period, SPM subtype (hematologic or non-hematologic), and initial age (< 30 years or ≥ 30 years). The HR within the target group was not significantly higher (< 1) in patients who received over 3.7 GBq of I-131 compared with patients who received less than 3.7 GBq of I-131 based on 95% CI.

CONCLUSION

There was no significant difference of the SPM risk between TC patients treated with I-131 and propensity-matched TC patients without I-131 therapy.

Address: Office of eHealth Research and Business, Seoul National University Bundang Hospital, 173rd Street, Gumi-ro, Seongnam-si 436-707, Republic of Korea.; Department of Nuclear Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.; Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.; Department of Biomedicine & Health Sciences, The Catholic University of Korea, Seoul, Republic of Korea.; Division of Nuclear Medicine, Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.; Transdisciplinary Department of Medicine & Advanced Technology, Seoul National University Hospital, Seoul, Republic of Korea.; Medical Big Data Research Center, Seoul National University Medical Research Center, Seoul, Republic of Korea.; Interdisciplinary Program in Bioengineering, Seoul National University, Seoul, Republic of Korea.; Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea.; Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.; Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Republic of Korea.; Department of Nuclear Medicine, Soonchunhyang University Bucheon Hospital, Gyeonggido, Republic of Korea.; Department of Statistics, Seoul National University, Seoul, South Korea.; Department of Statistics, Kyungpook National University, Daegu, South Korea.; Office of eHealth Research and Business, Seoul National University Bundang Hospital, 173rd Street, Gumi-ro, Seongnam-si 436-707, Republic of Korea. [email protected].; Department of Nuclear Medicine, Office of eHealth Research and Business, Seoul National University Bundang Hospital, 166, Gumi-ro, Seongnam-si 436-707, Republic of Korea. [email protected].

DOI: 10.1007/s00259-022-05779-9

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https://dx.doi.org/10.1007/s00259-022-05779-9

MeSH Terms: Adult, Data Science, Female, Humans, Informatics, Iodine Radioisotopes, Middle Aged, Neoplasms, Second Primary, Retrospective Studies, Thyroid Neoplasms