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Elisa Minaldi Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Via Paradisa, Pisa, Italy

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Virginia Cappagli Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Via Paradisa, Pisa, Italy

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

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Laura Valerio Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Via Paradisa, Pisa, Italy

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Carlotta Giani Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Via Paradisa, Pisa, Italy

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Matilde Viglione Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Via Paradisa, Pisa, Italy

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

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

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Antonio Matrone Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Via Paradisa, Pisa, Italy

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

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inhibitors (TKI) side effects in differentiated and medullary thyroid cancer patients . Best Practice and Research. Clinical Endocrinology and Metabolism 2017 31 349 – 361 ( https://doi.org/10.1016/j.beem.2017.04.012 ) 8 National Institutes of Health

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Sule Canberk Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal
Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Porto, Portugal
Abel Salazar Biomedical Sciences Institute (ICBAS), University of Porto, Porto, Portugal

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Joana C. Ferreira Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal
Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Porto, Portugal

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Luísa Pereira Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal
Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Porto, Portugal
Department of Pathology, Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal

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Rui Batısta Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal
Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Porto, Portugal

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Andre F. Vieira Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal
Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Porto, Portugal

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Paula Soares Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal
Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Porto, Portugal
Department of Pathology, Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal

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Manuel Sobrinho Simões Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal
Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Porto, Portugal
Department of Pathology, Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal
Abel Salazar Biomedical Sciences Institute (ICBAS), University of Porto, Porto, Portugal
Department of Pathology and Oncology, Centro Hospitalar São João, Porto, Portugal

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Valdemar Máximo Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Porto, Portugal
Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Porto, Portugal
Department of Pathology, Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal

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occur sporadically, but 3–9% are defined as familial non-medullary thyroid cancer (FNMTC). Less than 5% of FNMTC is seen in syndromic forms associated with well-defined driver germline alterations. This rare type of FNMTC includes Cowden syndrome

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Elen Dias Accordi Group for Advanced Molecular Investigation (NIMA), Graduate Program in Health Sciences (PPGCS), School of Medicine (EM), Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba

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Paraskevi Xekouki Section on Endocrinology and Genetics, Program on Developmental Endocrinology and Genetics (PDEGEN) and Pediatric Endocrinology Inter-Institute Training Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH)

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Bruna Azevedo Group for Advanced Molecular Investigation (NIMA), Graduate Program in Health Sciences (PPGCS), School of Medicine (EM), Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba

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Rodrigo Bertollo de Alexandre Group for Advanced Molecular Investigation (NIMA), Graduate Program in Health Sciences (PPGCS), School of Medicine (EM), Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba

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Carla Frasson Group for Advanced Molecular Investigation (NIMA), Graduate Program in Health Sciences (PPGCS), School of Medicine (EM), Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba
Álvaro Center for Analysis and Clinical Research - Diagnósticos da América (DASA), Cascavel, Brazil

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Siliane Marie Gantzel Group for Advanced Molecular Investigation (NIMA), Graduate Program in Health Sciences (PPGCS), School of Medicine (EM), Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba

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Georgios Z. Papadakis Department of Radiology and Imaging Sciences, Clinical Center, National Institutes of Health (NIH), Bethesda, Md., USA

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Anna Angelousi Section on Endocrinology and Genetics, Program on Developmental Endocrinology and Genetics (PDEGEN) and Pediatric Endocrinology Inter-Institute Training Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH)

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Constantine A. Stratakis Section on Endocrinology and Genetics, Program on Developmental Endocrinology and Genetics (PDEGEN) and Pediatric Endocrinology Inter-Institute Training Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH)

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Vanessa Santos Sotomaior Group for Advanced Molecular Investigation (NIMA), Graduate Program in Health Sciences (PPGCS), School of Medicine (EM), Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba

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Fabio R. Faucz Group for Advanced Molecular Investigation (NIMA), Graduate Program in Health Sciences (PPGCS), School of Medicine (EM), Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba
Section on Endocrinology and Genetics, Program on Developmental Endocrinology and Genetics (PDEGEN) and Pediatric Endocrinology Inter-Institute Training Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH)

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females [ 3 ]. There are two types of endocrine thyroid cells from which thyroid cancers are derived: follicular thyroid cells and parafollicular C cells [ 4 ]. Medullary thyroid cancers that are parafollicular thyroid C cells in origin have been

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Cosimo Durante Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy

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Laszlo Hegedüs Department of Endocrinology, Odense University Hospital, Odense, Denmark

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Agnieszka Czarniecka M. Sklodowska-Curie National Research, Institute of Oncology Gliwice Branch, Gliwice, Poland

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Ralf Paschke Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

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Gilles Russ Thyroid and Endocrine Tumors Department, Pitié-Salpêtrière Hospital, Sorbonne University GRC N°16, Paris, France

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Fernando Schmitt Faculty of Medicine of University of Porto, CINTESIS@RISE and Institute of Molecular Pathology and Immunology, University of Porto (Ipatimup), Porto, Portugal

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Paula Soares Institute of Investigation and Innovation in Health (I3S), Faculty of Medicine of the University of Porto, Porto, Portugal

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Tamas Solymosi Endocrinology and Metabolism Clinic, Bugat Hospital, Gyöngyös, Hungary

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Enrico Papini Department of Endocrine and Metabolic Diseases, Regina Apostolorum Hospital, Albano, Rome, Italy

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case of personal or family history of medullary thyroid cancer or multiple endocrine neoplasia type 2 ( 27 ). Cut-off points to separate non-medullary reasons for increased calcitonin from medullary thyroid carcinoma have been established (>30 pg/mL in

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Carla Colombo Endocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

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Daniele Ceruti Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy

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Massimiliano Succi Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy

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Simone De Leo Endocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy

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Matteo Trevisan Endocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy

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Claudia Moneta Department of Biotechnology and Translational Medicine, University of Milan, Milan, Italy

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Laura Fugazzola Endocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

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Introduction Tyrosine kinase inhibitors (TKIs) and target therapies are efficiently used in the treatment of progressive radioiodine-refractory differentiated thyroid cancer (RAI-R DTC) and advanced medullary thyroid cancer (MTC) ( 1 ). In

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Minoru Kihara Departments of Surgery, Kobe, Japan

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Akira Miyauchi Departments of Surgery, Kobe, Japan

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Hiroshi Yoshida Research, Kuma Hospital, Kobe, Japan

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Osamu Yamada Departments of Surgery, Kobe, Japan

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Hiroo Masuoka Departments of Surgery, Kobe, Japan

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Tomonori Yabuta Departments of Surgery, Kobe, Japan

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Takuya Higashiyama Departments of Surgery, Kobe, Japan

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Mitsuhiro Fukushima Departments of Surgery, Kobe, Japan

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Yasuhiro Ito Departments of Surgery, Kobe, Japan

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Kaoru Kobayashi Departments of Surgery, Kobe, Japan

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Akihiro Miya Departments of Surgery, Kobe, Japan

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.1002/hed.23241 23468374 13 American Thyroid Association Guidelines Task Force, Kloos RT, Eng C, Evans DB, Francis GL, Gagel RF, Gharib H, Moley JF, Pacini F, Ringel MD, Schlumberger M, Wells SA Jr: Medullary thyroid cancer: management guidelines of

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Fernanda Andrade Department of Medicine, Endocrinology Service, Instituto Nacional do Cancer (INCA), Rio de Janeiro, Brazil
Department of Medicine, Endocrinology Service, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil

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Danielle Probstner Department of Orthopedics and palliative care, Instituto Nacional do Cancer (INCA), Rio de Janeiro, Brazil

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Marcus Decnop Department of Radiology, Instituto Nacional do Cancer (INCA), Rio de Janeiro, Brazil

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Daniel Bulzico Department of Medicine, Endocrinology Service, Instituto Nacional do Cancer (INCA), Rio de Janeiro, Brazil

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Denise Momesso Department of Medicine, Endocrinology Service, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil

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Rossana Corbo Department of Medicine, Endocrinology Service, Instituto Nacional do Cancer (INCA), Rio de Janeiro, Brazil
Department of Medicine, Endocrinology Service, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil

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Mario Vaisman Department of Medicine, Endocrinology Service, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil

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Fernanda Vaisman Department of Medicine, Endocrinology Service, Instituto Nacional do Cancer (INCA), Rio de Janeiro, Brazil
Department of Medicine, Endocrinology Service, Hospital Universitário Clementino Fraga Filho, Rio de Janeiro, Brazil

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selection of patients included in the analysis. MTC, medullary thyroid cancer; ZA, zoledronic acid; SRE, skeletal related events. In this study, as a referral cancer center, we found that the bone metastases were usually present at diagnosis and

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Giorgio Grani Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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Livia Lamartina Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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Valeria Ramundo Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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Rosa Falcone Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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Cristiano Lomonaco Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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Laura Ciotti Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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Martina Barone Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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Marianna Maranghi Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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Vito Cantisani Diagnostic and Ultrasound Innovations Unit, Azienda Ospedaliera Universitaria Policlinico Umberto I, “Sapienza” University of Rome, Rome, Italy

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Sebastiano Filetti Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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Cosimo Durante Department of Translational and Precision Medicine, “Sapienza” University of Rome, Rome, Italy

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-variant papillary thyroid cancer ( n = 6); medullary thyroid cancer ( n = 2); papillary thyroid cancer ( n = 26); and metastases from other solid tumors ( n = 3). The other 3 nodules had cytological diagnoses of malignancy (TIR5, n = 1) or suspected malignancy

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Marta Di Stefano Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy

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Carla Colombo Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

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Simone De Leo Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy

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Michela Perrino Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy

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Mauro Viganò Division of Hepatology, San Giuseppe Hospital Multimedica IRCCS, Milan, Italy

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Luca Persani Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
Department of Clinical Sciences and Community Health, Milan, Italy

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Laura Fugazzola Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

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symptomatic, advanced or metastatic medullary thyroid cancer . J Clin Oncol . 2009 ; 27 ( 23 ): 3794 – 801 . http://dx.doi.org/10.1200/JCO.2008.18.7815 12 Sherman SI , Wirth LJ , Droz JP , Hofmann M , Bastholt L , Martins RG

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Ayanthi Wijewardene Department of Endocrinology, Royal North Shore Hospital, Sydney, New South Wales, Australia
Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia

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Matti Gild Department of Endocrinology, Royal North Shore Hospital, Sydney, New South Wales, Australia
Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia

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Carolina Nylén Endocrine Surgery Department, Royal North Shore Hospital, Sydney, New South Wales, Australia

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Geoffrey Schembri Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
Nuclear Medicine Department, Royal North Shore Hospital, Sydney, New South Wales, Australia

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Paul Roach Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
Nuclear Medicine Department, Royal North Shore Hospital, Sydney, New South Wales, Australia

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Jeremy Hoang Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
Nuclear Medicine Department, Royal North Shore Hospital, Sydney, New South Wales, Australia

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Ahmad Aniss Endocrine Surgery Department, Royal North Shore Hospital, Sydney, New South Wales, Australia

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Anthony Glover Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
Endocrine Surgery Department, Royal North Shore Hospital, Sydney, New South Wales, Australia

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Mark Sywak Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
Endocrine Surgery Department, Royal North Shore Hospital, Sydney, New South Wales, Australia

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Stan Sidhu Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
Endocrine Surgery Department, Royal North Shore Hospital, Sydney, New South Wales, Australia

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Diana Learoyd Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia

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Bruce Robinson Department of Endocrinology, Royal North Shore Hospital, Sydney, New South Wales, Australia
Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia

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Lyndal Tacon Department of Endocrinology, Royal North Shore Hospital, Sydney, New South Wales, Australia
Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia

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Roderick Clifton-Bligh Department of Endocrinology, Royal North Shore Hospital, Sydney, New South Wales, Australia
Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia

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thyroid cancer were excluded, along with lymphoma of the thyroid gland. RAI activities were categorized into 3 groups: low (<1.3 GBq, 35 mCi), intermediate (1.3–3.74 GBq; 35–101 mCi), and high (≥3.75 GBq; 101 mci). The high-activity group was further

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