Is More Always Better? Surgical Extent and Radioactive Iodine Treatment in N1b Intermediate-High-Risk Papillary Thyroid Cancer

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References

1. Ringel

, Sosa

, Baloch

, et al. 2025 American Thyroid Association management guidelines for adult patients with differentiated thyroid cancer. Thyroid 2025;35(8):841-985; doi: 10.1177/10507256251363120.

2. Fujiwara

, Kofuji

, Kishimoto

, et al. Are total thyroidectomy and adjuvant radioactive iodine treatment required in all patients with N1b intermediate-high risk papillary thyroid carcinoma? Thyroid 2026;36(1):36-45; doi: 10.1177/10507256251401241.

3. Abelleira

, Jerkovich

. Dynamic risk assessment in patients with differentiated thyroid cancer. Rev Endocr Metab Disord 2024;25(1):79-93; doi: 10.1007/s11154-023-09857-7.

4. Weis

, Weindler

, Schmidt

, Hellmich

, Drzezga

, Schmidt

. Impact of radioactive iodine treatment on long-term relative survival in patients with papillary and follicular thyroid cancer: A SEER-based study covering histologic subtypes and recurrence risk categories. J Nucl Med 2025;66(4):525-530; doi: 10.2967/jnumed.124.269091.

5. Cuéllar

, De Los Reyes

, Llamas-Olier

. Modified dynamic risk stratification system further predicts individual outcome in patients with intermediate-risk papillary thyroid cancer. Ann Endocrinol (Paris) 2023;84(2):242-248; doi: 10.1016/j.ando.2022.03.003.

6. Klain

, Nappi

, Zampella

, et al. Ablation rate after radioactive iodine therapy in patients with differentiated thyroid cancer at intermediate or high risk of recurrence: A systematic review and a meta-analysis. Eur J Nucl Med Mol Imaging 2021;48(13):4437-4444; doi: 10.1007/s00259-021-05440-x.

7. Momesso

, Vaisman

, Yang

, et al. Dynamic risk stratification in patients with differentiated thyroid cancer treated without radioactive iodine. J Clin Endocrinol Metab 2016;101(7):2692-2700; doi: 10.1210/jc.2015-4290.

8. Cho

, Lee

, Hong

, Yoon

. Dynamic risk stratification system in post-lobectomy low-risk and intermediate-risk papillary thyroid carcinoma patients. Clin Endocrinol (Oxf) 2018;89(1):100-109; doi: 10.1111/cen.13721.

9. Park

, Moon

, Nam

, Yoon

. Optimal timing of initiating dynamic risk stratification during the early postoperative period in patients with differentiated thyroid carcinoma after thyroidectomy and radioactive iodine remnant ablation. Ann Surg Oncol 2021;28(11):6580-6589; doi: 10.1245/s10434-021-09721-5.

10.

10. Kim

, Ryu

, Lee

, et al. Longitudinal changes in quality of life before and after thyroidectomy in patients with differentiated thyroid cancer. J Clin Endocrinol Metab 2024;109(6):1505-1516; doi: 10.1210/clinem/dgad748.