title: Low-risk papillary thyroid carcinoma patients who underwent near-total thyroidectomy without prophylactic central compartment lymph node dissection and were ablated with low-dose 50mCi RAI had excellent 10-year prognosis.
abstract: BACKGROUND
  The current trend in the management of low risk differentiated thyroid carcinoma is to follow less aggressive strategies.
  
  
  OBJECTIVE
  To assess the long-term morbidity and mortality outcomes of low-risk papillary thyroid carcinoma (PTC) patients undergoing minimal intervention.
  
  
  METHODS
  We retrospectively analyzed 137 patients with low-risk PTC (stage I: n=77; stage II: n=60). Of these patients, 107 (Group 1) had macro-PTC and underwent near-total thyroidectomy and received postoperatively 50mCi RAI. The remaining 30 patients (Group 2) had micro-PTC (<1cm) and were treated only by means of near-total thyroidectomy.
  
  
  RESULTS
  The median follow-up for Group 1 patients was 10 years (range: 3-30). At 1-year evaluation, 8 patients of Group 1 had indeterminate or incomplete biochemical response, of whom 4 had also incomplete structural response to initial therapy. Only 1 of 4 patients with structural incomplete response underwent cervical lymph node dissection and then received an additional dose of 100mCi RAI. The remaining 7 patients received only an additional dose of 100mCi RAI. These patients have been continuously followed till the present time with no recurrences or deaths (median follow-up: 17.5 years; 3-30 years). At 15 years, 2 patients of Group 1 experienced biochemical recurrence and they received 100mCi RAI. Three patients of Group 2 experienced recurrence, with 2 receiving 50mCi RAI and 1 undergoing cervical lymph node dissection with 50mCi RAI.
  
  
  CONCLUSIONS
  Patients with low-risk macro-PTC treated by means of near-total thyroidectomy without PCCLND and receiving postoperatively a low dose of 50mCi RAI have excellent long-term prognosis.
authors.affiliation: Endocrine Division, Internal Medicine Department, University of Patras, Medical School, Rion, Patras, Greece. mixmar@med.upatras.gr.|University Hospital of Patras, Rion, Patras, 26500, Greece. mixmar@med.upatras.gr.
authors.forename: Marina
authors.initials: M
authors.lastname: Michalaki
authors.affiliation: Endocrine Division, Internal Medicine Department, University of Patras, Medical School, Rion, Patras, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Bountouris
authors.affiliation: Endocrine Division, Internal Medicine Department, University of Patras, Medical School, Rion, Patras, Greece.
authors.forename: Nikolaos D
authors.initials: ND
authors.lastname: Roupas
authors.affiliation: Endocrine Division, Internal Medicine Department, University of Patras, Medical School, Rion, Patras, Greece.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Theodoropoulou
authors.affiliation: Endocrine Division, Internal Medicine Department, University of Patras, Medical School, Rion, Patras, Greece.
authors.forename: Niki
authors.initials: N
authors.lastname: Agalianou
authors.affiliation: Endocrine Division, Internal Medicine Department, University of Patras, Medical School, Rion, Patras, Greece.
authors.forename: Theodoras
authors.initials: T
authors.lastname: Alexandrides
authors.affiliation: Endocrine Division, Internal Medicine Department, University of Patras, Medical School, Rion, Patras, Greece.
authors.forename: Kostas
authors.initials: K
authors.lastname: Markou
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000532:radiotherapy* / Q000601:surgery*; D002291:Carcinoma, Papillary; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D011878:Radiotherapy / Q000379:methods*; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*