title: Follow-up of low-risk patients with differentiated thyroid carcinoma: a European perspective.
abstract: OBJECTIVE
  Because differentiated (follicular and papillary) thyroid cancer (DTC) may recur years after initial treatment, the follow-up of patients with DTC is long term. However, this population has changed, with more individuals being discovered at an earlier stage of the disease, so that previous follow-up protocols based mostly on data from high-risk patients no longer apply. We sought to develop an improved protocol for the follow-up of low-risk patients with DTC based on the findings of recent studies.
  
  
  METHODS
  We analysed recent literature on the follow-up of DTC.
  
  
  RESULTS
  Recent large studies have produced three important findings: (i) in patients with low-risk DTC with no evidence of disease up to the 6- to 12-month follow-up, diagnostic whole-body scan adds no information when serum thyroglobulin (Tg) is undetectable and interference from anti-Tg antibodies is absent; (ii) use of recombinant human thyroid-stimulating hormone to aid Tg measurement is effective and provides greater safety, quality-of-life and work productivity than does levothyroxine withdrawal with its attendant hypothyroidism; and (iii) ultrasonography performed by an experienced operator is the most sensitive means of detecting neck recurrences of DTC.
  
  
  CONCLUSIONS
  We present a revised follow-up protocol for low-risk patients taking into account the above findings. This protocol should help clinicians enter a new era of monitoring characterized by greater safety, simplicity, convenience and cost savings.
authors.affiliation: Institut Gustave Roussy, Villejuif, France. schlumbg@igr.fr
authors.forename: Martin
authors.initials: M
authors.lastname: Schlumberger
authors.forename: Gertrud
authors.initials: G
authors.lastname: Berg
authors.forename: Ohad
authors.initials: O
authors.lastname: Cohen
authors.forename: Leonidas
authors.initials: L
authors.lastname: Duntas
authors.forename: François
authors.initials: F
authors.lastname: Jamar
authors.forename: Barbara
authors.initials: B
authors.lastname: Jarzab
authors.forename: Eduard
authors.initials: E
authors.lastname: Limbert
authors.forename: Peter
authors.initials: P
authors.lastname: Lind
authors.forename: Furio
authors.initials: F
authors.lastname: Pacini
authors.forename: Christoph
authors.initials: C
authors.lastname: Reiners
authors.forename: Franco
authors.initials: F
authors.lastname: Sánchez Franco
authors.forename: Anthony
authors.initials: A
authors.lastname: Toft
authors.forename: Wilmar M
authors.initials: WM
authors.lastname: Wiersinga
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000097:blood / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy; D002291:Carcinoma, Papillary / Q000097:blood / Q000175:diagnosis* / Q000556:secondary; D002985:Clinical Protocols / Q000592:standards; D003663:Decision Trees; D005060:Europe; D005500:Follow-Up Studies; D008207:Lymphatic Metastasis; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000000981:diagnostic imaging; D017410:Practice Guidelines as Topic; D011994:Recombinant Proteins; D012306:Risk; D013954:Thyroglobulin / Q000097:blood*; D013964:Thyroid Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D011994:Recombinant Proteins; D013954:Thyroglobulin