Controversies about Radioactive Iodine-131 Remnant Ablation in Low Risk Thyroid Cancers: Are We Near A Consensus?

Well differentiated thyroid cancers (WDTC), including papillary (80%) and follicular (10%) types, are themost common endocrine cancers globally. Over the last few decades most the diagnosed cases have fallen intolow risk categories. Radioactive iodine-131 (RAI) has an established role in reducing recurrence and improvingthe survival in high risk patients. In patients with primary tumor size <1 cm, RAI is not recommended by manythyroid societies. However, low risk WDTC has been an arena of major controversies, most importantly therole and dose of adjuvant RAI for remnant ablation to minimize chances of recurrence and improving survival.This review is an attempt to update readers about the previous and existing practice based on results of nonrandomizedtrials and evolving trends fueled by recently published randomized studies.