Ablative radioactive iodine therapy for apparently localized thyroid carcinoma. A decision analytic perspective

Adjuvant therapy with ablative radioiodine after surgical resection of apparently localized thyroid carcinoma remains controversial because of the favorable prognosis of thyroid carcinoma and the risk of leukemia from the radioiodine. No controlled trials have been performed to examine this issue. We constructed a decision analytic model to examine whether patients with apparently localized thyroid carcinoma should receive radioiodine. Our analysis suggests that radioiodine modestly improves life expectancy by 2 to 15 months, depending on the patient's age and sex. This model predicts that the benefit of a reduction in the likelihood of recurrence outweighs the risk of leukemia from radioiodine.