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Updated: Apr 18, 2026

Computer-Aided Three-Dimensional Visualization in the Treatment of Locally Advanced Thyroid Cancer

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VALIDATION OF THE 2025 ATA RISK STRATIFICATION SYSTEM IN A COHORT OF PATIENTS WITH PAPILLARY THYROID CARCINOMA.

Claudia Moneta¹, Matteo Trevisan^1,2, Carla Colombo^3,4

¹Department of Health Sciences, University of Milan, Italy.

The Journal of Clinical Endocrinology and Metabolism

|April 17, 2026

Summary

The 2025 American Thyroid Association (ATA) guidelines for papillary thyroid cancer (PTC) risk stratification shift patients to higher-risk categories. A new "low-intermediate-risk" group requires further study for optimal management.

Keywords:

ATA risk stratification American Thyroid Association disease outcome papillary thyroid cancer risk factors structural recurrence or persistence

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Published on: June 2, 2023

Area of Science:

Endocrinology
Oncology
Surgical Oncology

Background:

The 2025 American Thyroid Association (ATA) guidelines update papillary thyroid cancer (PTC) risk stratification.
Real-world validation of this updated system is currently lacking.

Purpose of the Study:

To validate the 2025 ATA risk stratification system in a real-world setting.
To assess the impact of reclassification on predicting disease outcomes for PTC patients.

Main Methods:

Retrospective observational study including 670 PTC patients from a tertiary care center.
Comparison of patient redistribution between the 2015 and 2025 ATA risk stratification systems.
Evaluation of structural disease persistence based on the updated risk categories.

Main Results:

The 2025 system decreased 'low-risk' PTC by 22.2% and increased 'intermediate-risk' and 'high-risk' categories.
A new 'low-intermediate-risk' class emerged with a structural disease persistence risk between the 2015 'low-risk' and 'intermediate-risk' classes.
The 2025 'high-risk' classification showed comparable structural disease persistence to the 2015 system.

Conclusions:

The 2025 ATA risk stratification system reclassifies PTC patients towards higher-risk categories in a real-world setting.
The novel 'low-intermediate-risk' class requires further investigation due to its distinct recurrence risk profile.
Prospective studies are needed to determine appropriate management strategies for the newly defined risk groups.