11
Figure 3. Risk of Structural Disease Recurrence
(In patients without structurally identifiable disease after
initial therapy)
High Risk
Gross extrathyroidal
extension, incomplete
tumor resection, distant
metastases, or lymph
node >3 cm
Intermediate Risk
Aggressive histology,
minor extrathyroidal
extension, vascular
invasion, or
>5 involved lymph
nodes (0.2–3 cm)
Low Risk
Intrathyroidal DTC
≤5 LN micrometastases
(<0.2 cm)
FTC, extensive vascular invasion (≈30–55%)
pT4a gross ETE (≈30–40%)
pN1 with extranodal extension, >3 LN
involved (≈40%)
PTC, >1 cm, TERT mutated ± BRAF
mutated* (>40%)
pN1, any LN >3 cm (≈30%)
PTC, extrathyroidal, BRAF mutated*
(≈10–40%)
PTC, vascular invasion (≈15–30%)
Clinical N1 (≈20%)
pN1, >5 LN involved (≈20%)
Intrathyroidal PTC, <4 cm, BRAF mutated
(≈10%)
pT3 minor ETE (≈3–8%)
pN1, all LN <0.2 cm (≈5%)
pN1, ≤5 LN involved (≈5%)
Intrathyroidal PTC, 2–4 cm (≈5%)
Multifocal PTMC (≈4–6%)
pN1 without extranodal extension,
≤3 LN involved (2%)
Minimally invasive FTC (≈2-3%)
Intrathyroidal, <4 cm, BRAF wild type*
(≈1–2%)
Intrathryroidal unifold PTMC, BRAF
mutated*, (≈1–2%)
Intrathyroidal, encapsulated, FV-PTC
(≈1–2%)
Unifocal PTMC (≈1–2%)
* While analysis of BRAF and/or TERT status is not routinely recommended for initial risk
stratification, we have included these findings to assist clinicians in proper risk stratification in
cases where this information is available.
Haugen BR, 2015 American yroid Association Management Guidelines for adult Patients with
yroid Nodules and Differentiated yroid Cancer. yroid. Vol 26, Number 1, 2016
DTC: Long-Term Management and
Advanced Cancer Management
