{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:01:30Z","timestamp":1790006490526,"version":"4.0.1"},"reference-count":33,"publisher":"Bioscientifica","issue":"5","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Patients with differentiated thyroid carcinoma (DTC) classified as low risk of recurrence and an excellent response to initial treatment should have a particularly low risk of recurrence. Our objective was to assess the recurrence rate in these patients to support follow-up de-escalation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicenter retrospective study was conducted in six Spanish hospitals, including consecutive patients diagnosed with low-risk DTC between 2015 and 2018 with an excellent response to initial therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 379 patients were included, with a median follow-up of 6.7 years. Response to therapy at the last follow-up, according to the 2015 ATA\/Momesso criteria, was excellent in 349 patients (92.1%), indeterminate in 29 (7.6%), and biochemical incomplete in 1 (0.3%). The overall incidence of indeterminate response was 11.8 events per 1,000 person-years, peaking at year 3 of follow-up and dropping to nearly zero after year 7. PTC and RAI treatment were associated with a lower probability of developing an indeterminate response (P = 0.02 and P = 0.03, respectively). When applying the 2025 ATA criteria, the excellent response rate increased to 95.8% and neither papillary histology nor RAI treatment was significantly associated (P = 0.07 and P = 0.61, respectively). During follow-up, indeterminate\/suspicious findings on ultrasound were observed in 39 patients (10.3%). FNA was performed in 20 of these, none of which found recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Recurrences in patients with low risk of recurrence and an excellent response to initial therapy are extremely infrequent. These data support follow-up de-escalation in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance statement<\/jats:title>\n                    <jats:p>In this multicenter retrospective study of low-risk DTC patients with an excellent response to initial treatment, no recurrences were observed among 379 patients after a median follow-up of 6.7 years. The overall incidence rate of indeterminate response was 11.8 events per 1,000 person-years, peaking around year 3 after surgery and progressively declining thereafter, approaching zero after year 7. Using the 2025 ATA response-to-therapy criteria, 95.8% of patients maintained an excellent response at the last follow-up, and no variable was associated with the development of an indeterminate response. These findings support follow-up de-escalation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/etj-26-0223","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T17:53:37Z","timestamp":1787939617000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-17","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of patients with low-risk differentiated thyroid cancer with an excellent response to initial therapy"],"prefix":"10.1530","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2529-1502","authenticated-orcid":true,"given":"Carlos","family":"Garcia-Regal","sequence":"first","affiliation":[{"name":"Universidad de Alcal\u00e1 1 , ,","place":["Madrid, Spain"]},{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Ram\u00f3n y Cajal, IRYCIS 2 , ,","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6061-9751","authenticated-orcid":true,"given":"Jhonatan","family":"Qui\u00f1ones-Silva","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Ram\u00f3n y Cajal, IRYCIS 2 , ,","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1097-1436","authenticated-orcid":true,"given":"Noemi","family":"Brox-Torrecilla","sequence":"additional","affiliation":[{"name":"Universidad de Alcal\u00e1 1 , ,","place":["Madrid, Spain"]},{"name":"Department of Endocrinology and Nutrition, Hospital Universitario Ram\u00f3n y Cajal, IRYCIS 2 , ,","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3218-2550","authenticated-orcid":true,"given":"Alberto","family":"Martinez-Lorca","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Hospital Universitario Ram\u00f3n y Cajal, IRYCIS 3 , ,","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2298-4683","authenticated-orcid":true,"given":"Ignacio","family":"Ruz-Caracuel","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hospital Universitario Ram\u00f3n y Cajal, IRYCIS 4 , ,","place":["Madrid, Spain"]},{"name":"CIBERONC 5 , ,","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9ctor","family":"Pian Arias","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hospital Universitario Ram\u00f3n y Cajal, IRYCIS 4 , ,","place":["Madrid, 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