Radioiodine remnant ablation (RRA) Impact on the dynamic risk of restratification in the short-term follow-up of patients with differentiated thyroid cancer (DTC).

Background: Post-surgical management of the DTC is based on the dynamic stratification of the risk of recurrence, according to the 2015 ATA guidelines [Excellent (ExR), Biochemical Incomplete (BiR), Structural Incomplete (StR) and Indeterminate Response (InR)]. The aim of this study was to evaluate the impact of RRA in the short-term follow-up of the DTC patients. Matherials and Methods: We retrospectively evaluated the clinico-pathological data of 807 consecutive DTC patients who were submitted to RRA in our Department. The initial class of risk, defined on the basis of the histological criteria, has been reclassified: 1) After the first post-operative evaluation. 2) Including the result of post therapeutic Whole Body Scan (ptWBS). 3) At the moment of the first post-RRA evaluation. Results: see Table 1. Conclusions: 3. Dynamic risk restratification could begin immediately after surgery, taking into account the value of Tg, TgAb and the result of neck US. 4. The results of the ptWBS, did not change the further diagnostic and therapeutic strategy in most of the LR and IR patients. 5. The main impact of RRA in LR and IR is the effect on serum Tg levels, which is one of the cornerstones of dynamic risk restratification, even more relevant after 131-I therapy.