Abstract
Differentiated thyroid carcinoma (DTC) is a relatively common endocrine malignancy. Of these cancers, papillary cancer comprises about 85% of cases compared to about 10% with follicular histology, and 3% that are Hürthle cell or oxyphil tumours. Papillary thyroid carcinoma (PTC) greater than 1cm in diameter is best managed by total thyroidectomy. Postoperatively, radioactive iodine ablation followed by thyroid stimulating hormone (TSH) suppression is indicated in certain patients to improve locoregional control and reduce recurrence. To decide whether ablation is worthwhile, the TNM classification is recommended which is a system that provides the rationale for therapy and the strength of existing evidence for or against treatment. Several histological subtypes of PTC, the presence of intrathyroidal vascular invasion, or the finding of gross or microscopic multifocal disease may place the patient at higher risk of local recurrence or metastases. Moreover, the size of the tumour, lymph node status, and patient age may increase the risk of recurrence or metastatic spread to a degree that is high enough to ablate these patients. The minimum activity of radioactive iodine necessary to achieve successful remnant ablation is suggested, particularly for low-risk patients.
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Palimeri, S., Gousis, P. & Vlassopoulou, B. Indications of radioactive iodine ablation in papillary thyroid cancer. Hellenic J Surg 87, 53–57 (2015). https://doi.org/10.1007/s13126-015-0180-y
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DOI: https://doi.org/10.1007/s13126-015-0180-y