Endocrine Abstracts

Differentiated Thyroid Cancer (DTC) is the most common malignant tumor in endocrinology, being the papillary subtype frequently found. The DTC is usually indolent and with a more favorable clinical prognosis of survival in 10 years, which has been diagnosed more frequently after the development and dissemination of complementary detection methods, according to the world literature. However, access to imaging exams with increasing resolving power makes a large number of low-risk patients suffer unnecessary and aggressive treatment. To overcome this new reality, the current guidelines, such as ATA 2015, have changed the way that this disease is treated and classified, in order to prevent the low-risk patients to be overtreated. The objective of this paper was toidentify if the current treatment guidelines for DTC have impacted the decision to use less iodine therapy after thyroidectomy. We performed a retrospective cross-sectional, quantitative, observational analysis of patients diagnosed with DTC, submitted to thyroidectomy with their respective treatment histories and clinical and laboratory follow-up data. In the sample of 201 patients, of the 54 staged as intermediate risk by ATA 2009, 16 (30%) were stratified to low risk by ATA 2015. A percentage of 26,5%(n= 18) of microcarcinomas were diagnosed since 2015, being significantly larger (n= 17 (12,8%) than those treated before the new classification (P-value = 0,019). However, patients who maintained the low-risk classification had a mean ablative dose of 61,92 mCi, while the 16 patients who were reclassified from intermediate to low risk in 2015, has a mean dose of 97,5 mCi. In conclusion, the DTC is being treated in smaller tumors but continues to be treated with high doses of radioiodine associated with total thyroidectomy, when they could have been submitted to cheaper surgery or even active surveillance. Thus, despite a significant change in estranging due to updates in the latest guideline, in medical practice there I still a wide variation in the management of low-risk DTC.