{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:38:01Z","timestamp":1776818281679,"version":"3.51.2"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The clinical utility of postoperative radioiodine therapy in patients with low-risk differentiated thyroid cancer (DTC) remains a subject of ongoing debate. Although radioiodine has been widely employed to reduce the risk of recurrence, its necessity in low-risk populations is increasingly questioned, given the favorable outcomes observed with surgery alone. To address this issue, we conducted a meta-analysis exclusively based on randomized controlled trials (RCTs) to comprehensively evaluate the efficacy and safety of radioiodine therapy in this specific patient population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched 6 databases for eligible phase 3 RCTs comparing surgery with or without radioiodine in patients with low-risk DTC. Primary outcomes included recurrence and recurrence-free survival (RFS); secondary outcomes included adverse events (AEs), structural events, and biological events. Risk ratios (RRs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled and analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two phase 3 RCTs (the ESTIMABL2 and IoN trials), encompassing 1280 patients, were included. Compared to the non-radioiodine group, radioiodine therapy did not significantly reduce recurrence rates (RR: 0.78 [0.36-1.70],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.53) or improve RFS (HR: 0.96 [0.80-1.15],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.68). The total number of structural events (RR: 0.83 [0.68-1.02],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.07) and biological events (RR: 0.88 [0.71-1.08],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.23) were also similar between the two groups. In the safety analysis, the two groups exhibited comparable rates of AEs (RR: 0.97 [0.79-1.20],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.80), grade 3\u20135 AEs (RR: 0.25 [0.03-2.20],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.21), death (RR: 1.28 [0.48-3.41],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.62), and second primary cancers (RR: 1.26 [0.58-2.73],\n                      <jats:italic>P<\/jats:italic>\n                      = 0.55).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Radioiodine therapy did not confer significant benefits in reducing recurrence or improving RFS in patients with low-risk DTC after thyroidectomy, and the safety profiles were comparable between the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:uri>https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:uri>\n                      , identifier CRD420251105509.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2025.1670978","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T05:18:10Z","timestamp":1761628690000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Is radioiodine necessary for patients with low-risk differentiated thyroid cancer after thyroidectomy: a pooled analysis of ESTIMABL2 and IoN trials"],"prefix":"10.3389","volume":"15","author":[{"given":"Chuansheng","family":"Yang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deping","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingting","family":"Zou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenchun","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linfeng","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3322\/caac.21871","article-title":"Cancer 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