DTC: Long-Term Management and
Advanced Cancer Management
18
ATA low to intermediate risk No, except
possibly in
subgroup of
patients ≥45
years of age
(NTCTCSG
Stage III)
Conflicting
observational
data
Consider
a
– generally
favored, due to
somewhat higher
risk of persistent or
recurrent disease,
especially with
increasing number
of large (>2-3 cm)
or clinically evident
lymph nodes or
presence of extra-
nodal extension.
Advancing age may
also favor RAI use.
b
However, there is
insufficient data to
mandate RAI use
in patients with few
(<5) microscopic
nodal metastases in
central compartment
in absence of other
adverse features.
T1–3
N1a
M0, Mx
Central
compartment
neck lymph
node
metastases
ATA low to intermediate risk No, except
possibly in
subgroup of
patients ≥45
years of age
Conflicting
observational
data
Consider
a
– generally
favored, due to higher
risk of persistent or
recurrent disease,
especially with
increasing number
of macroscopic or
clinically evident
lymph nodes or
presence of extra-
nodal extension.
Advancing age may
also favor RAI use.
b
T1–3
N1b
M0, Mx
Lateral neck
or mediastinal
lymph node
metastases
Table 6. Characteristics According to the ATA Risk
Stratification System and AJCC/TNM Staging
System That May Affect Post-operative RAI
Decision-Making (cont'd)
ATA recurrence risk
Body of Evidence
Suggests
RAI Improves
Disease- Specific
Survival?
Body of
Evidence
Suggests
RAI Improves
Disease-Free
Survival?
Post-Surgical RAI
Indicated?
Staging
T N M Description
