Recommendations for post-surgical thyroid ablation in differentiated thyroid cancer: a 2015 position statement of the Italian Society of Endocrinology.
Post-surgical ablation of thyroid remnant with radioactive iodine (RAI) in differentiated thyroid cancer (DTC) is aimed to destroy any thyroid remnant in the thyroid bed (remnant ablation) and any microscopic foci of cancer cells eventually present within the thyroid remnant (adjuvant therapy). The present text is an attempt to offer practice guidelines for the indication of thyroid ablation and the preparation of DTC patients considering the latest achievement in the field and the changing epidemiology of DTC observed in the last 10 years.


METHODS
The executive committee of the Italian Society of Endocrinology appointed a task force of thyroid cancer expert including Nuclear Medicine Physicians and Endocrinologists to provide a consensus on the post-surgical ablation in thyroid cancer patients. The task force had no conflict of interest and had no commercial support. A number of specific topics were selected and the members selected relevant papers by searching in the Pubmed for articles published from 2000 to January 2015. Selected studies were categorized by level of evidence, and the recommendations were graded according to the level of evidence as high (A), moderate (B), or low (C).
Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy. pacini8@unisi.it.|Department of Endocrinology, University of Siena, Via Bracci, 53100, Siena, Italy. pacini8@unisi.it.
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F
Pacini
Nuclear Medicine Unit, Ospedale Civile di Macerata, Macerata, Italy.
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E
Brianzoni
Department of Internal Medicine and Medical Specialties, University of Rome Sapienza, Rome, Italy.
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C
Durante
Endocrine Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
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R
Elisei
Nuclear Medicine Unit, University of Verona, Verona, Italy.
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M
Ferdeghini
Endocrine Unit, Fondazione IRCCS Ca' Granda Policlinico, Milan, Italy.|Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
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L
Fugazzola
Department Medical Sciences "M. Aresu", University of Cagliari, Cagliari, Italy.
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S
Mariotti
Endocrinology Division, Garibaldi Nesima Hospital, Palermo, Italy.
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Pellegriti
D000230:Adenocarcinoma / Q000628:therapy*; D017115:Catheter Ablation; D002454:Cell Differentiation; D004704:Endocrinology; D006801:Humans; D007558:Italy; D011182:Postoperative Care; D017410:Practice Guidelines as Topic / Q000592:standards*; D012955:Societies, Medical; D013964:Thyroid Neoplasms / Q000628:therapy*
Radioiodine; Thyroglobulin; Thyroid ablation; Thyroid cancer; rhTSH