Postsurgical radioiodine ablation in low-risk differentiated thyroid cancer

Since the first demonstration by Mazzaferri and colleagues 1 Mazzaferri EL Young RL Oertel JE Kemmerer WT Page CP Papillary thyroid carcinoma: the impact of therapy in 576 patients. Medicine (Baltimore). 1977; 56: 171-196 Crossref PubMed Scopus (421) Google Scholar that the administration of radioiodine therapy after total thyroidectomy for differentiated thyroid cancer reduced mortality and recurrences, such treatment strategy became the standard of care for patients with thyroid cancer. At that time, no distinction was made regarding clinical, pathological, or radiological features. Subsequently, the same authors 2 Mazzaferri EL Jhiang SM Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med. 1994; 97: 418-428 Summary Full Text PDF PubMed Scopus (2188) Google Scholar reported that postoperative thyroid ablation with radioiodine was mostly effective in stage II and III disease and that 1·1 GBq (30 mCi) doses were as effective as 3·7 GBq (100 mCi) doses. Nevertheless, in daily clinical practice, the majority of patients were candidates to receive an ablative dose of radioiodine (usually 100 mCi) without selection.