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Laura Agate Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

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Francesca Bianchi Unit of Endocrine and Oncological Nuclear Medicine Therapy, Diagnostic and Imaging Department, University of Pisa, Pisa, Italy

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Federica Brozzi Unit of Endocrine and Oncological Nuclear Medicine Therapy, Diagnostic and Imaging Department, University of Pisa, Pisa, Italy

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Pierina Santini Unit of Endocrine and Oncological Nuclear Medicine Therapy, Diagnostic and Imaging Department, University of Pisa, Pisa, Italy

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Eleonora Molinaro Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

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Valeria Bottici Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

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David Viola Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

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Loredana Lorusso Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

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Paolo Vitti Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

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Rossella Elisei Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

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the potential secondary side effects, particularly in patients with low-risk (LR) and intermediate-risk (IR) DTC, even if these effects are negligible for RAI activities < 100 mCi [ 5 - 7 ]. Nowadays, there is a general agreement that LR DTC should not

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Syed Ali Imran Division of Endocrinology, Dalhousie University, Halifax, Nova Scotia, Canada

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Karen Chu Department of Oncology, University of Alberta, Edmonton, Alberta, Canada

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Murali Rajaraman Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia, Canada

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Drew Rajaraman Division of Endocrinology, Dalhousie University, Halifax, Nova Scotia, Canada

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Sunita Ghosh Department of Oncology, University of Alberta, Edmonton, Alberta, Canada

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Sarah De Brabandere Department of Diagnostic Imaging, Western University, London, Ontario, Canada

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Stephanie M. Kaiser Division of Endocrinology, Dalhousie University, Halifax, Nova Scotia, Canada

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Stan Van Uum Department of Medicine, Western University, London, Ontario, Canada

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detection of small, subclinical tumours which contribute to the rising incidence of TC [ 11 ]. Regardless, the outlook of TC is generally excellent, with an overall 5-year survival of 97.9%, and that of low-risk TC (stage I and II) is almost 100% [ 12

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Aglaia Kyrilli Department of Endocrinology, Hôpital Universitaire de Bruxelles (H.U.B.)– Hôpital Erasme, Université Libre de Bruxelles (ULB), Route de Lennik 808, Brussels, Belgium

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Nunzia Tacelli Department of Radiology, Hôpital Universitaire de Bruxelles (H.U.B.)– Hôpital Erasme, Université Libre de Bruxelles (ULB), Route de Lennik 808, Brussels, Belgium

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Lucia Russo Department of Medicine, DIMED, Internal Medicine 3, University of Padua, Via Giustiniani 2, 35128, Padova, Italy

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Laetitia Lebrun Department of Pathology, Hôpital Universitaire de Bruxelles (H.U.B.)– Hôpital Erasme, Université Libre de Bruxelles (ULB), Route de Lennik 808, Brussels, Belgium

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Isabelle Salmon Department of Pathology, Hôpital Universitaire de Bruxelles (H.U.B.)– Hôpital Erasme, Université Libre de Bruxelles (ULB), Route de Lennik 808, Brussels, Belgium

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Gilles Russ Thyroid and Endocrine Tumors, Institute of Endocrinology, Pitié Salpêtrière Hospital, Pierre et Marie Curie University, Paris, France

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Rodrigo Moreno-Reyes Department of Nuclear Medicine, Hôpital Universitaire de Bruxelles (H.U.B.)– Hôpital Erasme, Université Libre de Bruxelles (ULB), Route de Lennik, Brussels, Belgium

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Bernard Corvilain Department of Endocrinology, Hôpital Universitaire de Bruxelles (H.U.B.)– Hôpital Erasme, Université Libre de Bruxelles (ULB), Route de Lennik 808, Brussels, Belgium

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(US), the first-line tool to stratify malignancy risk of thyroid nodules, does not, unlike scintigraphy, evaluate the nodule’s functional characteristics. The utility to effectively diagnose AFTN relies on the generally admitted assumption that AFTN

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Cláudia C.D. Nakabashi Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil
Fleury Medicina e Saúde, São Paulo, Brazil

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Teresa S. Kasamatsu Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo

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Felipe Crispim Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo

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Claudia A. Yamazaki Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo

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Cléber P. Camacho Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Danielle M. Andreoni Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Rosalia P. Padovani Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Elza S. Ikejiri Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Maria C.O.M. Mamone Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Flávia C. Aldighieri Fleury Medicina e Saúde, São Paulo, Brazil

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Jairo Wagner Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Jairo T. Hidal Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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José G.H. Vieira Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Fleury Medicina e Saúde, São Paulo, Brazil

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Rosa P.M. Biscolla Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil
Fleury Medicina e Saúde, São Paulo, Brazil

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Rui M.B. Maciel Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil
Fleury Medicina e Saúde, São Paulo, Brazil

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a nonsignificant risk of recurrence from undergoing unnecessary investigations and identify those individuals with a higher risk who merit closer follow-up [ 6 , 7 ]. The measurement of serum thyroglobulin (Tg) levels is one of the most important

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Furio Pacini Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy

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therapy by cleaning persistent microscopic foci of cancer, which can be present in the thyroid remnant. While the first aim - remnant ablation - is related to follow-up in any patient regardless of his specific risk, the second one - adjuvant therapy - is

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David J. Stott University of Glasgow, Glasgow, UK

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Douglas C. Bauer University of California, San Francisco, Calif., USA

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Ian Ford University of Glasgow, Glasgow, UK

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Patricia Kearney University College of Cork, Cork, Ireland

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Jacobijn Gussekloo Leiden University Medical Centre, Leiden

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Terence J. Quinn University of Glasgow, Glasgow, UK

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Nicolas Rodondi Inselspital, Bern University Hospital, Bern, Switzerland

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Jan Smit Radboud University Medical Centre, Nijmegen, The Netherlands

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Rudi Westerdorp Leyden Academy on Vitality and Ageing, Leiden

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useful background and guidance, we suggest that the approach recommended there carries potential risks, with the likely outcome of an increase in the proportion of ‘younger' elderly patients treated for SCH and the withholding of thyroxine treatment in

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Axel Sahovaler Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada
Guided Therapeutics (GTx) Program, Techna Institute, University Health Network, Toronto, Ontario, Canada

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Marco Ferrari Guided Therapeutics (GTx) Program, Techna Institute, University Health Network, Toronto, Ontario, Canada
Unit of Otorhinolaryngology – Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health, University of Brescia, Brescia, Italy
Section of Otorhinolaryngology – Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy

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Jonathan Athayde Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada

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Adrian Mendez Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada

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Kevin Fung Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada

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John Yoo Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada

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Anthony C. Nichols Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada

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S. Danielle MacNeil Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada

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Dear Editor, The recently published “Systematic Review of Recurrence Rate after Hemithyroidectomy for Low-Risk Well-Differentiated Thyroid Cancer” (WDTC) by Chan et al. [ 1 ] aimed to focus on tumors between 1 and 4 cm, which represent the

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Chitra Choudhary Department of Endocrinology, Medstar Washington Hospital Center, Washington, D.C., USA

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Leonard Wartofsky Department of Endocrinology, Medstar Washington Hospital Center, Washington, D.C., USA

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Eshetu Tefera MedStar Health Research Institute, Washington, D.C., USA

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Kenneth D. Burman Department of Endocrinology, Medstar Washington Hospital Center, Washington, D.C., USA

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ultrasonography, with occasional imaging by MRI, FDG-PET or 131 I scanning depending on the clinical context. Neck ultrasound is recommended at 6-12 months after surgery and then less frequently depending on the risks for loco-regional recurrence [ 1 , 2

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Samuel Chan Department of Ear, Nose and Throat Surgery, Lanesborough Wing, St George’s Hospital, London, United Kingdom

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Katarina Karamali Department of Ear, Nose and Throat Surgery, Lanesborough Wing, St George’s Hospital, London, United Kingdom

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Anna Kolodziejczyk Department of Ear, Nose and Throat Surgery, Lanesborough Wing, St George’s Hospital, London, United Kingdom

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Georgio Oikonomou Department of Ear, Nose and Throat Surgery, Lanesborough Wing, St George’s Hospital, London, United Kingdom

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John Watkinson Department of Ear, Nose and Throat Surgery, GOSH, London, United Kingdom

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Vinidh Paleri Head and Neck Unit, The Royal Marsden Hospital, London, United Kingdom

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Iain J. Nixon Department of Ear, Nose and Throat Surgery, NHS Lothian, Lauriston Building, University of Edinburgh, Edinburgh, United Kingdom

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Dae Kim Department of Ear, Nose and Throat Surgery, Lanesborough Wing, St George’s Hospital, London, United Kingdom

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data, we have shown that the pooled recurrence rate after HT in all included studies, as well as a subset of these studies that define a low-risk cohort of patients, is approximately 9% in both groups. We found this rate to be marginally but

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Leonidas H. Duntas Endocrine Unit, Evgenidion Hospital, University of Athens, Athens, Greece

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Georg Brabant Medizinische Klinik I, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany

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Fabio Monzani Department of Clinical and Experimental Medicine, Università di Pisa, Pisa, Italy

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Simon H.S. Pearce Institute of Genetic Medicine, Newcastle University, UK
Royal Victoria Infirmary, Newcastle upon Tyne, UK

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Robin Patrick Peeters Rotterdam Thyroid Center, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands

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Salman Razvi Institute of Genetic Medicine, Newcastle University, UK
Queen Elizabeth Hospital, Gateshead, UK

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Jean-Louis Wemeau Clinique Endocrinologique Marc-Linquette, CHU, Lille, France

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We appreciate the interest of Stott et al. [ 1 ] in the Management of Subclinical Hypothyroidism ETA Guidelines 2013 [ 2 ]. We are, however, somewhat puzzled by the authors' statement that the guidelines ‘risk doing more harm than good

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