Endocrine Abstracts

Regarding the debate about whether we should still ablate all patients undergoing total thyroidectomy, the answer is no. Most thyroid cancer patients have an excellent prognosis with a normal life expectancy and among them most of them have a low risk of recurrence. The absence of ablation in patients with thyroid cancer of 1 centimeter or less (pT1a) is already widely applied, so, we are used not to ablate all thyroid cancer patients treated with total thyroidectomy. The question, indeed, is whether the group of patients not undergoing systemic ablation can be extended beyond pT1aN0/x patients. The selection of patients to be spared from ablation can indeed be based on pathology examination, on tumour size, on lymph node involvement and since some of these patients are now recognized as low risk patients. The selection can also be based on postoperative thyroglobulin level because of its excellent negative predictive, whether measured after TSH stimulation or measured under levothyroxine treatment with ultrasensitive method, and on neck ultrasonography. However, prospective randomized trials are needed in order to answer this question of ablation. This will allow reinforcing the strength of recommendation that can be done.