{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:38:42Z","timestamp":1792600722155,"version":"4.5.0"},"reference-count":16,"publisher":"The Endocrine Society","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Sarah Stanton Endowment Grant Funding"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Differentiated thyroid cancer (DTC) is increasingly managed with total thyroidectomy (TT) without radioactive iodine (RAI). An unstimulated thyroglobulin (Tg) \u22640.2\u2005ng\/mL has traditionally defined remission. The 2025 American Thyroid Association (ATA) guideline raised the threshold to 2.5\u2005ng\/mL to reduce overtreatment. We evaluated the performance of this cutoff in clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective study of patients with DTC treated with TT without RAI between 2001 and 2023. Eligible patients had more than 3 years of follow-up, undetectable anti-thyroglobulin antibody, and negative initial imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 2781 screened patients, 205 met inclusion criteria: 118 were ATA low-, 42 low-intermediate, and 45 intermediate-high risk disease. Mean follow-up was 85 months. Using the revised Tg threshold (&amp;lt;2.5\u2005ng\/mL) increased the excellent response group from 76% to 98%. Among ATA low-risk patients, no structural recurrences were missed. However, 3.5% of patients with low-intermediate or higher-risk disease developed structural recurrence despite meeting excellent response criteria. The median time to recurrence was 22 months. In these patients, a postoperative Tg cutoff of 0.3\u2005ng\/mL demonstrated 100% sensitivity for structural recurrence. No thyroid cancer-related deaths occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The 2025 ATA Tg threshold increased excellent response classification without missing recurrence in low-risk patients. However, structural recurrences occurred in patients with higher-risk disease below the revised cutoff, suggesting that Tg thresholds may require risk-adapted interpretation. Continued imaging surveillance remains important for patients with low-intermediate or higher recurrence risk, even when Tg criteria for excellent response are met under the 2025 ATA guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgag425","type":"journal-article","created":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T11:38:06Z","timestamp":1791718686000},"source":"Crossref","is-referenced-by-count":0,"title":["Risk-stratified outcomes using the 2025 ATA thyroglobulin cutoff after total thyroidectomy in differentiated thyroid cancer"],"prefix":"10.1210","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7191-0314","authenticated-orcid":false,"given":"Mayumi","family":"Endo","sequence":"first","affiliation":[{"name":"Division of Metabolism, Endocrinology, and Nutrition, University of Washington , Seattle, WA 98195, 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