Thyroidectomy without Radioiodine in Patients with Low-Risk Thyroid Cancer

This phase 3 randomized trial evaluated whether thyroidectomy without postoperative radioiodine (¹³¹I) ablation is noninferior to radioiodine therapy in patients with low risk differentiated thyroid cancer (DTC). Among 730 evaluable patients, the 3 year event free rates were 95.6% (no radioiodine) and 95.9% (radioiodine), meeting noninferiority criteria (difference: 0.3 percentage points; 90% CI: 2.7 to 2.2). Events included structural/functional abnormalities (8 patients) and elevated thyroglobulin/antibodies (23 patients). No treatment related adverse events occurred. Molecular analysis revealed no significant genomic differences between groups. The study concludes that omitting radioiodine in low risk DTC does not compromise outcomes, supporting its avoidance to reduce unnecessary treatment.

This phase 3 randomized trial evaluated whether thyroidectomy without postoperative radioiodine (¹³¹I) ablation is noninferior to radioiodine therapy in patients with low risk differentiated thyroid cancer (DTC). Among 730 evaluable patients, the 3 year event free rates were 95.6% (no radioiodine) and 95.9% (radioiodine), meeting noninferiority criteria (difference: 0.3 percentage points; 90% CI: 2.7 to 2.2). Events included structural/functional abnormalities (8 patients) and elevated thyroglobulin/antibodies (23 patients). No treatment related adverse events occurred. Molecular analysis revealed no significant genomic differences between groups. The study concludes that omitting radioiodine in low risk DTC does not compromise outcomes, supporting its avoidance to reduce unnecessary treatment.