Acknowledging gray areas: 2015 vs. 2009 American Thyroid Association differentiated thyroid cancer guidelines on ablating putatively low-intermediate-risk patients

Purpose Typically formulated by investigators from “world centres of excellence,” differentiated thyroid carcinoma (DTC) management guidelines may have more limited applicability in settings of less expert care and fewer resources. Arguably the world’s leading DTC guidelines are those of the American Thyroid Association, revised in 2009 (“ATA 2009”) and 2015 (“ATA 2015”). To further explore the issue of “real-world applicability” of DTC guidelines, we retrospectively compared indications for ablation using ATA 2015 versus ATA 2009 in a two-centre cohort of ablated T1–2, M0 DTC patients (N = 336). Based on TNM status and histology, these patients were low–intermediate risk, but many ultimately had other characteristics suggesting elevated or uncertain risk.