DTC: Long-Term Management and
Advanced Cancer Management
14
Figure 2. Clinical Decision-making and Management
Recommendations in ATA Low Risk Differentiated Thyroid
Cancer Patients That Have Undergone Less than Total
Thyroidectomy (Lobectomy or Lobectomy with Isthmusectomy)
Initial Therapy
Lobectomy (R35)
RAI Remnant Ablation Not Routinely Recommended
(R38B)
Evaluation of Post-Operative Disease Status
• Consider post-op serum thyroglobulin (R50B, R50C)
• Neck ultrasound (thyroid, central and lateral neck compartments)
should be considered if not performed properatively
Initial TSH Goal
0.5-2 mU/L (R59E)
Evalutation Response to Therapy
• Neck US (R65)
• Consider Tg testing (R62B, R64)
Excellent Response to Therapy
• Primary follow-up with clinical exam and
non-stimulated Tg (R64)
• TSH goal 0.5-2.0 mU/L
(R70E, Table 8)
• Non-stimulated Tg 12-24 month intervals
(R62C)
• Periodic US examinations (R65)
Biochemical Incomplete
(rising serum Tg),
Structural Incomplete,
or Indeterminate Response
See text for guidance
