title: Radioiodine remnant ablation in low-risk differentiated thyroid cancer: the "con" point of view.
abstract: A growing body of evidence is challenging the indiscriminate use of postoperative radioiodine for remnant ablation (RRA) in low-risk (LR) differentiated thyroid cancer patients. We critically reviewed the current evidence on which the rationale for RRA is based for LR patients and analyzed the new evidence-based recommendations for LR patients from the draft of the 2015 American Thyroid Association (ATA) guidelines. Cost-effective tools for staging and follow-up, such as neck ultrasonography and serial thyroglobulin testing, are useful for monitoring non-RRA-treated patients. Recurrence rates are very low in non-RRA-treated LR patient cohorts. Most RRA side effects are mild and transient, but can impair a patient's quality of life. RRA is appropriately not routinely recommended in LR patients according to the draft 2015 ATA guidelines and should be reserved for higher-risk patients.
authors.affiliation: Department of Internal Medicine and Medical Specialties, University of Rome Sapienza, Viale del Policlinico 155, 00161, Rome, Italy, livialamartina@gmail.com.
authors.forename: Livia
authors.initials: L
authors.lastname: Lamartina
authors.forename: David S
authors.initials: DS
authors.lastname: Cooper
mesh_terms: D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects / Q000494:pharmacology*; D018365:Neoplasm, Residual / Q000532:radiotherapy*; D013964:Thyroid Neoplasms / Q000532:radiotherapy* / Q000601:surgery
chemical_list: D007457:Iodine Radioisotopes