This protocol addresses the next clinical step for patients with papillary thyroid carcinoma at low estimated risk of recurrence — intrathyroidal disease staged T1a, T1b, or T2 with no locoregional lymph node metastases (N0) — who did not reach the required response milestones following primary surgical management.
Low-risk papillary thyroid carcinoma confined to the thyroid (T1a–T2, N0). Two large database studies on surgical management strategies found that, for selected low-risk tumours in this stage range, lobectomy alone does not reduce overall survival.
Initial management with lobectomy — or alternatively total thyroidectomy with or without prophylactic central neck dissection — did not achieve excellent response to therapy: the targets of negative imaging, undetectable anti-thyroglobulin antibodies, and serum thyroglobulin <0.2 ng/ml (or stimulated thyroglobulin <1 ng/ml), as assessed 6–18 months after treatment, were not met. This protocol represents the structured next step following that shortfall.
DOI: 10.1093/annonc/mdz400
Two large database studies on surgical management strategies found that, for selected low-risk tumours (T1a–T1b–T2, N0), lobectomy alone does not reduce OS.
There is less consensus regarding other low-risk DTCs: if RAI is given, low activities (30 mCi, 1.1 GBq) following rhTSH administration are recommended.
To eliminate the normal thyroid remnant, thereby ensuring undetectable serum Tg levels (in the absence of neoplastic tissue), which facilitate follow-up (remnant ablation).
View source ↗