{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T03:12:47Z","timestamp":1788405167986,"version":"build-2803163510"},"reference-count":25,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>To enhance sodium-iodide symporter expression and, thereby, radiopharmaceutical uptake\/retention in differentiated thyroid carcinoma (DTC) metastases, radioiodine therapy (RAIT) can be stimulated by recombinant human TSH (rhTSH) or thyroid hormone withdrawal (THW). We investigated the association of thyrotropin (TSH) stimulation methodology with treatment outcomes in patients with radioiodine-avid distantly metastatic DTC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Single-center retrospective cohort study involving 189 consecutive eligible patients initiating RAIT from 2005 to 2015, a period allowing sufficient follow-up to adequately assess long-term outcomes. Patients were dichotomized into \u201crhTSH only\u201d or \u201cmixed stimulation\u201d subgroups (respectively, all RAIT activities prepared by rhTSH or \u22651 activity prepared using THW;\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 81,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 108). Patients given only THW (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 5) were excluded due to low numbers for statistical analysis. Endpoints comprised radiological\/biochemical response and time-to-progression (TTP) and overall survival (OS) estimated via the Kaplan\u2013Meier method. Unadjusted inter-subgroup differences underwent log-rank testing; multivariable Cox modeling assessed independent associations with TTP and OS of disease\/treatment characteristics, including stimulation methodology. Propensity score matching was performed to reduce baseline differences between the stimulation groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Median (minimum\u2013maximum) follow-up was 123 (3\u2013182) months. The best radiologic response consisted predominantly of stable disease (49%), with complete and partial responses observed in 23% and 18% of patients, respectively, and progressive disease in 10%, without significant differences between the TSH stimulation subgroups. Unadjusted analyses favored the mixed subgroup regarding TTP (141 vs. 42 months;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.05) and OS (116 vs. 68 months;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.01). However, after adjustment, TSH stimulation method was not independently associated with these outcomes; metastatic burden (macrometastasis) and age at DTC diagnosis were the strongest independent predictors. Consistent results were observed in the propensity score-matched cohort, with no significant differences in TTP or OS between stimulation groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In radioiodine-avid metastatic DTC, rhTSH or mixed rhTSH\/THW preparation is associated with comparable adjusted outcomes. Prognosis appears to be chiefly driven by metastatic burden and age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Implications:<\/jats:title>\n                    <jats:p>In patients with radioiodine-avid metastatic DTC, the choice between rhTSH and THW should be individualized based on comorbidities, logistics, and patient preference rather than an assumed difference in oncologic efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10507256261448724","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T10:28:10Z","timestamp":1778754490000},"page":"641-653","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["TSH Stimulation Methods are Associated with Comparable Outcomes in Radioiodine-Avid Metastatic Differentiated Thyroid Cancer: Single Center Retrospective Observational Study"],"prefix":"10.1177","volume":"36","author":[{"given":"Aleksandra","family":"Ledwon","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa","family":"Paliczka-Cie\u015blik","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Kropi\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandra","family":"Blew\u0105ska","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Czarniecka","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa","family":"Chmielik","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolanta","family":"Krajewska","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawe\u0142","family":"Cie\u015blik","sequence":"additional","affiliation":[{"name":"Department of Internal, Autoimmune Diseases and Diabetology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Jarz\u0105b","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0802-2880","authenticated-orcid":false,"given":"Daria","family":"Handkiewicz-Junak","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,14]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/10507256251363120"},{"key":"e_1_3_4_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_3_4_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13139-018-0540-y"},{"key":"e_1_3_4_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-024-13313-3"},{"key":"e_1_3_4_6_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-19-0149"},{"issue":"6","key":"e_1_3_4_7_1","first-page":"15N","article-title":"SNMMI procedure standard\/EANM practice guideline for nuclear medicine evaluation and therapy of differentiated thyroid cancer: Abbreviated version","volume":"63","author":"Avram AM","year":"2022","unstructured":"6.Avram AM, , Giovanella L, , Greenspan B, et al. 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