AccScience Publishing / EJMO / Online First / DOI: 10.36922/EJMO025010556
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ORIGINAL RESEARCH ARTICLE

Association of adjuvant radioactive iodine therapy with cancer-specific survival in columnar cell papillary thyroid carcinoma: A population‑based analysis

Lan Zhang1 ,  Yuling Su2 ,  Shilian Huang1 ,  Qiteng Lu1 ,  Zhixiao Wei1* ,  Hui Zhou3*
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1 Department of Nuclear Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
2 Department of Nuclear Medicine, Zhuhai People’s Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, Guangdong, China
3 Department of Nuclear Medicine and Minnan PET Center, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
EJMO, 025010556 https://doi.org/10.36922/EJMO025010556
Received: 30 December 2025 | Revised: 13 February 2026 | Accepted: 3 March 2026 | Published online: 6 April 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Introduction: Columnar cell papillary thyroid carcinoma (CCPTC) is a rare histological phenotype with controversial prognostic implications. Whether adjuvant radioactive iodine (RAI) confers a cancer-specific survival (CSS) benefit in this population remains uncertain.

Objective: This study utilized a population-based registry to evaluate the impact of postoperative RAI on CSS in patients with CCPTC following thyroidectomy.

Methods: Individuals with CCPTC undergoing total thyroidectomy (2004–2015) were identified from Surveillance, Epidemiology, and End Results. After exclusions, 754 eligible patients (535 RAI, 219 no RAI) were included. Propensity score matching (1:1, caliper 0.1) balanced baseline characteristics. Cox regression estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for CSS. A nomogram integrating independent prognostic factors was constructed to predict 5-, 8-, and 10-year CSS.

Results: After matching, 187 balanced pairs were generated. Multivariable Cox analysis revealed no significant CSS difference between RAI-treated and untreated groups in the overall cohort (HR: 0.75; 95% CI: 0.35–1.61; p = 0.46) or the propensity matched cohort (HR: 0.58; 95% CI: 0.16–2.04; p = 0.39). Subgroup analyses stratified by age, sex, tumor size, extrathyroidal extension, nodal status, and disease stage consistently found no CSS benefit from RAI (all p > 0.05). The nomogram demonstrated satisfactory predictive accuracy for 5-, 8-, and 10-year CSS.

Conclusion: In this real-world CCPTC cohort, adjuvant RAI was not associated with improved CSS, even among high-risk patients. Routine RAI administration may be unwarranted. These findings require validation through prospective, multicenter studies with extended follow-up and comprehensive treatment data.

Keywords
Columnar cell
Papillary thyroid carcinoma
Radioactive iodine
Therapy
Survival
Funding
This work was supported by the Guangxi Natural Science Foundation (grant number: 2023GXNSFAA026069).
Conflict of interest
The authors declare they have no competing interests.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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