Treatment and follow-up of low-risk patients with thyroid cancer

The postoperative administration of radioiodine can be avoided in low-risk patients with undetectable TSH-stimulated serum thyroglobulin and no lymph-node metastases detected at surgery. Sensitive methods for serum thyroglobulin determination can be used to avoid TSH stimulation 9-12 months after surgery in low-risk patients who have an undetectable serum thyroglobulin on levothyroxine treatment; the role of these sensitive assays in the period immediately after surgery needs to be established by further studies. Finally, a low activity of radioiodine (1.1 GBq) should be administered selectively in low-risk patients receiving levothyroxine treatment following injections of recombinant human TSH. These modifications of current protocols will improve the quality of life of patients, potentially decrease morbidity and considerably reduce the cost of treatment and follow-up.