RESPONSE ASSESSMENT AFTER HEMITHYROIDECTOMY FOR DIFFERENTIATED THYROID CARCINOMA USING THE 2025 ATA GUIDELINES: A SINGLE CENTRE EXPERIENCE
Abstract
Background: The 2025 American Thyroid Association guidelines introduced response to therapy criteria for patients undergoing hemithyroidectomy but do not recommend thyroglobulin thresholds or serial monitoring after lobectomy. We evaluated treatment response using the 2025 criteria and assessed the utility of residual lobe thyroglobulin. Methods: We retrospectively reviewed 26 consecutive patients undergoing hemithyroidectomy between June 2022 and December 2025 at a tertiary endocrine centre. Histopathology was available in 20 patients, excluding two non-invasive follicular thyroid neoplasms and 18 differentiated thyroid carcinoma cases. ATA risk categories were assigned using the 2025 stratification system. Response was assessed from ≥3 months postoperatively using ultrasound findings, unstimulated thyroglobulin was analyzed descriptively. Results: Mean age was 34.2±7.1 years, and 94.1% were female. Histology included classical papillary thyroid carcinoma (n=6), follicular variant papillary thyroid carcinoma (n=5), minimally invasive follicular thyroid carcinoma (n=2), papillary microcarcinoma (n=2), invasive encapsulated follicular variant papillary thyroid carcinoma (n=2), and oncocytic carcinoma (n=1). Median tumour size was 2.4 cm, with 25% measuring >4 cm. At a median follow-up of 7 months, 12/13 patients achieved an excellent response, while one was indeterminate because of an unbiopsied suspicious level VI lymph node. No structurally incomplete responses occurred. Median unstimulated thyroglobulin was 11.4 ng/mL, exceeding 5 ng/mL in 76% despite no confirmed structural disease. Conclusions: Residual lobe thyroglobulin was frequently elevated yet poorly discriminated disease status, supporting the 2025 ATA recommendation that ultrasound, rather than thyroglobulin, should guide postoperative response assessment after lobectomy. These findings reinforce ultrasound based surveillance for low-risk patients undergoing hemithyroidectomy.
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BibTeX
@article{patil2026response,
title = {{RESPONSE ASSESSMENT AFTER HEMITHYROIDECTOMY FOR DIFFERENTIATED THYROID CARCINOMA USING THE 2025 ATA GUIDELINES: A SINGLE CENTRE EXPERIENCE}},
author = {Madhu S. Patil and Subramanian Kannan and K. S. Shivaprasad and Kranti Shreesh Khadilkar and G. S. Basavaraj and Anirudh J. Shetty and N. Vikas and K. S. Naveen and Floris Ann Francis},
journal = {Thyroid Research \& Practice},
year = {2026},
month = oct,
doi = {10.4103/trp.trp_51_26},
url = {https://doi.org/10.4103/trp.trp_51_26},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - RESPONSE ASSESSMENT AFTER HEMITHYROIDECTOMY FOR DIFFERENTIATED THYROID CARCINOMA USING THE 2025 ATA GUIDELINES: A SINGLE CENTRE EXPERIENCE
AU - Madhu S. Patil
AU - Subramanian Kannan
AU - K. S. Shivaprasad
AU - Kranti Shreesh Khadilkar
AU - G. S. Basavaraj
AU - Anirudh J. Shetty
AU - N. Vikas
AU - K. S. Naveen
AU - Floris Ann Francis
PY - 2026
DA - 2026/10/01
JO - Thyroid Research & Practice
DO - 10.4103/trp.trp_51_26
UR - https://doi.org/10.4103/trp.trp_51_26
AB - Background: The 2025 American Thyroid Association guidelines introduced response to therapy criteria for patients undergoing hemithyroidectomy but do not recommend thyroglobulin thresholds or serial monitoring after lobectomy. We evaluated treatment response using the 2025 criteria and assessed the utility of residual lobe thyroglobulin. Methods: We retrospectively reviewed 26 consecutive patients undergoing hemithyroidectomy between June 2022 and December 2025 at a tertiary endocrine centre. Histopathology was available in 20 patients, excluding two non-invasive follicular thyroid neoplasms and 18 differentiated thyroid carcinoma cases. ATA risk categories were assigned using the 2025 stratification system. Response was assessed from ≥3 months postoperatively using ultrasound findings, unstimulated thyroglobulin was analyzed descriptively. Results: Mean age was 34.2±7.1 years, and 94.1% were female. Histology included classical papillary thyroid carcinoma (n=6), follicular variant papillary thyroid carcinoma (n=5), minimally invasive follicular thyroid carcinoma (n=2), papillary microcarcinoma (n=2), invasive encapsulated follicular variant papillary thyroid carcinoma (n=2), and oncocytic carcinoma (n=1). Median tumour size was 2.4 cm, with 25% measuring >4 cm. At a median follow-up of 7 months, 12/13 patients achieved an excellent response, while one was indeterminate because of an unbiopsied suspicious level VI lymph node. No structurally incomplete responses occurred. Median unstimulated thyroglobulin was 11.4 ng/mL, exceeding 5 ng/mL in 76% despite no confirmed structural disease. Conclusions: Residual lobe thyroglobulin was frequently elevated yet poorly discriminated disease status, supporting the 2025 ATA recommendation that ultrasound, rather than thyroglobulin, should guide postoperative response assessment after lobectomy. These findings reinforce ultrasound based surveillance for low-risk patients undergoing hemithyroidectomy.
SN - 0973-0354
SN - 2250-1452
ER -