Ablation of the thyroid remnant and I-131 dose in differentiated thyroid cancer: a meta-analysis revisited.

Postoperative ablation of functioning thyroid tissue has become established in the management of differentiated thyroid cancer as the long-term risk of recurrence and death is reduced. This beneficial effect results from the destruction of potentially malignant cells or occult multifocal disease that may occur in up to 30% of patients with papillary tumors1-4 Furthermore, the specificity of thyroglobulin as a tumor marker is increased and the sensitivity of subsequent whole body scans seems improved because residual thyroid tissue may compete with recurrent or metastatic thyroid cancer cells for radioiodine uptake.5 Indeed, it has been demonstrated that patients with successful ablation of remnant thyroid tissue have a better prognosis than those with unsuccessful ablation (disease-free survival of 87% versus 49% after 10 years, while thyroid cancer-related survival was 93% versus 78%).6 This suggests that it is important to achieve complete ablation as soon as possible after diagnosis in order to ensure the best possible prognosis for a patient.