title: [Postoperative radioiodine ablation in patients with low risk differentiated thyroid carcinoma].
abstract: Most patients with newly diagnosed differentiated thyroid carcinoma have tumors with low risk of mortality and recurrence. Standard therapy has been total or near total thyroidectomy followed by postoperative radioiodine remnant ablation (RRA). Although RRA provides benefits, current clinical guidelines do not recommend it universally, since an increase in disease-free survival or a decrease in mortality in low risk patients has not been demonstrated so far. Advancements in our understanding of the biological behavior of thyroid cancer have been translated into the clinic in a personalized approach to the patients based on their individual risk of recurrence and mortality. Current evidence suggests that RRA is not indicated in most low-risk patients, especially those with papillary carcinomas smaller than 1cm, without extrathyroidal extension, unfavorable histology, lymph node involvement or distant metastases. Follow-up of these patients with serial measurements of serum thyroglobulin and neck ultrasound is adequate. Careful evaluation of all risk factors of clinical relevance will allow a more realistic assessment of each individual patient.
authors.affiliation: Servicio de Endocrinología, Hospital Ramón y Cajal, Madrid, España; Departamento de Medicina, Universidad de Alcalá de Henares, Alcalá de Henares, Madrid, España. Electronic address: juanjose.diez@salud.madrid.org.
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Díez
authors.affiliation: Servicio de Oncología Médica, Hospital Ramón y Cajal, Madrid, España.
authors.forename: Enrique
authors.initials: E
authors.lastname: Grande
authors.affiliation: Servicio de Endocrinología, Hospital Ramón y Cajal, Madrid, España.
authors.forename: Pedro
authors.initials: P
authors.lastname: Iglesias
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D000359:Aftercare; D014408:Biomarkers, Tumor / Q000097:blood; D002291:Carcinoma, Papillary / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D007457:Iodine Radioisotopes / Q000008:administration & dosage / Q000627:therapeutic use*; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000000981:diagnostic imaging; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D012306:Risk; D018570:Risk Assessment; D013954:Thyroglobulin / Q000097:blood; D013964:Thyroid Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D014408:Biomarkers, Tumor; D007457:Iodine Radioisotopes; D013954:Thyroglobulin
keywords: Ablación; Ablation; Bajo riesgo; Cáncer diferenciado de tiroides; Differentiated thyroid cancer; Iodine-131; Low risk; Medicina personalizada; Personalized medicine; Radioiodine; Radioyodo; Yodo-131