<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2307-3349</journal-id>
<journal-title><![CDATA[Revista de salud publica del Paraguay]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. salud publica Parag.]]></abbrev-journal-title>
<issn>2307-3349</issn>
<publisher>
<publisher-name><![CDATA[INSTITUTO NACIONAL DE SALUD - MSP Y BS]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2307-33492024000100040</article-id>
<article-id pub-id-type="doi">10.18004/rspp.2024.abr.07</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Guía de práctica clínica para el tratamiento y seguimiento de personas con cáncer diferenciado de tiroides. Parte I: Vigilancia activa]]></article-title>
<article-title xml:lang="en"><![CDATA[Clinical practice guideline for the treatment and follow-up of people with differentiated thyroid cancer. Part I: Active surveillance]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Romero Gómez]]></surname>
<given-names><![CDATA[Fabiola]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Galiana Rodríguez]]></surname>
<given-names><![CDATA[María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Escurra Sánchez]]></surname>
<given-names><![CDATA[Clara]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cabrera]]></surname>
<given-names><![CDATA[Natalia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cárdenas Aguilera]]></surname>
<given-names><![CDATA[Juan Guillermo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Chacón Acevedo]]></surname>
<given-names><![CDATA[Kelly]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Valinotti Delmás]]></surname>
<given-names><![CDATA[Elizabeth]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto de Previsión Social  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Ministerio de Salud Pública y Bienestar Social Dirección General de Vigilancia de la Salud Registro de Cáncer]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Pontificia Universidad Javeriana Facultad de Medicina ]]></institution>
<addr-line><![CDATA[Bogotá ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Fundación Universitaria Sanitas Grupo de investigación traslacional ]]></institution>
<addr-line><![CDATA[Bogotá ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2024</year>
</pub-date>
<volume>14</volume>
<numero>1</numero>
<fpage>40</fpage>
<lpage>50</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2307-33492024000100040&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2307-33492024000100040&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2307-33492024000100040&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  El cáncer de tiroides es una enfermedad frecuente en el mundo, con mayor prevalencia del tipo diferenciado. El diagnóstico temprano y manejo pertinente, individualizado y adaptable puede mejorar su pronóstico.  Objetivo:  Generar recomendaciones basadas en evidencia sobre el tratamiento y seguimiento de personas adultas con cáncer diferenciado de tiroides (CDT).  Metodología:  Guía de práctica clínica (GPC) a partir de revisión sistemática de literatura (RSL) y consenso de expertos clínicos. El grupo desarrollador definió el alcance y cuatro preguntas que se resolvieron a través de revisión de evidencia de GPC existentes, RSL, estudios primarios publicadas en español o inglés en diferentes fuentes de información desde 2013. Las preguntas de investigación fueron: 1. ¿Cuáles son las indicaciones de la vigilancia activa?, ¿cómo realizarla?, ¿cuándo y con que periodicidad realizarla? 2. ¿Cuál es el tratamiento y su indicación en pacientes con nódulos tiroideos sospechosos de cáncer? 3. ¿Cómo y cuándo realizar seguimiento de pacientes con CDT de acuerdo con el riesgo dinámico? 4. ¿Cuál es el manejo actual de los pacientes iodo refractarios? Se propusieron recomendaciones basadas en la evidencia, y analizadas y discutidas por el colectivo experto en sesiones asincrónicas. Se evalúo la calidad de la evidencia y las recomendaciones fueron gradadas en fuerte o condicional y a favor o en contra a partir del análisis de la calidad de la evidencia, contexto de implementación (disponibilidad e implementación) y la experticia clínica. En el presente documento se desarrollada la primera pregunta, referente a vigilancia activa.  Resultados:  86 recomendaciones fueron propuestas y acordadas por el grupo desarrollador, categorizadas en tratamiento y seguimiento para resolver las preguntas planteadas. 10 de las recomendaciones corresponden a vigilancia activa y se incluyen en el presente documento. Recomendaciones claves incluyen, brindar información completa y oportuna a pacientes, conformación de equipos multidisciplinarios, análisis individualizado del paciente para la decisión de tratamiento, estadificación rutinaria de riesgo dinámico para evaluar la respuesta al tratamiento y ajustarlo, minimización de procedimientos fútiles o que aportan poco a la supervivencia y calidad de vida de los pacientes.  Conclusión:  Se presentan recomendaciones que esperan incidir en la estandarización de la práctica clínica cotidiana de pacientes con CDT y mejores resultados en salud.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Thyroid cancer is a common disease in the world, with a higher prevalence of the differentiated type. Early diagnosis individualized and adaptive management can improve prognosis.  Objective:  Generate evidence-based recommendations on the treatment and follow-up of adults with differentiated thyroid carcinoma (DTC).  Methodology:  Clinical practice guideline (CPG) based on systematic literature review (RSL) and consensus of clinical experts. The development group defined the range and four questions that were resolved through a review of evidence from existing CPGs, RSLs, primary studies published in Spanish or English in various sources of information since 2013. The research questions were: 1. What are the indications for active surveillance? How to carry it out? When and how often to carry it out? 2. What is the treatment and its indication in patients with thyroid nodules suspicious for cancer? 3. How and when to follow up patients with CDT according to dynamic risk? 4. What is the current management of iodine refractory patients? Evidence-based recommendations analyzed and discussed by the expert group in asynchronous sessions were proposed. The quality of the evidence was evaluated, and the recommendations were graded as strong or conditional and in favor or against based on the analysis of the quality of the evidence, implementation context (availability and implementation) and clinical expertise. In this document, is developed the first question, referring to active surveillance.  Results:  86 recommendations were proposed and agreed upon by the development group, categorized into treatment and follow-up to solve the questions raised. 10 of the recommendations correspond to active surveillance and are included in this document. Key recommendations include providing complete and timely information to patients, develop of multidisciplinary teams, individualized patient analysis for treatment decisions, routine dynamic risk staging to evaluate response to treatment and adjust it, minimization of futile procedures or that contribute little to the survival and quality of life of patients.  Conclusion:  Recommendations are presented that longs to influence the standardization of the daily clinical practice of patients with DTC and better health outcomes.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[nódulo tiroideo]]></kwd>
<kwd lng="es"><![CDATA[cáncer papilar tiroideo/tratamiento]]></kwd>
<kwd lng="es"><![CDATA[neoplasias de la tiroides]]></kwd>
<kwd lng="es"><![CDATA[seguimiento]]></kwd>
<kwd lng="en"><![CDATA[thyroid nodule]]></kwd>
<kwd lng="en"><![CDATA[papillary thyroid carcinoma/ therapy]]></kwd>
<kwd lng="en"><![CDATA[thyroid neoplasms/ surgical procedures]]></kwd>
<kwd lng="en"><![CDATA[follow-up cares]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bao]]></surname>
<given-names><![CDATA[WQ]]></given-names>
</name>
<name>
<surname><![CDATA[Zi]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Yuan]]></surname>
<given-names><![CDATA[QQ]]></given-names>
</name>
<name>
<surname><![CDATA[Li]]></surname>
<given-names><![CDATA[LY]]></given-names>
</name>
<name>
<surname><![CDATA[Deng]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Global burden of thyroid cancer and its attributable risk factors in 204 countries and territories from 1990 to 2019]]></article-title>
<source><![CDATA[Thorac Cancer]]></source>
<year>2021</year>
<volume>12</volume>
<numero>18</numero>
<issue>18</issue>
<page-range>2494-503</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sung]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Ferlay]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Siegel]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
<name>
<surname><![CDATA[Laversanne]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Soerjomataram]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Jemal]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Global Cancer]]></article-title>
<source><![CDATA[Statistics]]></source>
<year>2020</year>
<page-range>GLOBOCAN</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="">
<collab>American Cancer Society</collab>
<source><![CDATA[About thyroid cancer. What is thyroid cancer?]]></source>
<year>2023</year>
<page-range>p. 1-13</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fugazzola]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Elisei]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Fuhrer]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Jarzab]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Leboulleux]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Newbold]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[2019 European Thyroid Association Guidelines for the Treatment and Follow-Up of Advanced Radioiodine-Refractory Thyroid Cancer]]></article-title>
<source><![CDATA[European Thyroid Journal]]></source>
<year>2019</year>
<volume>8</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>227-45</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lin]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Aiello Bowles]]></surname>
<given-names><![CDATA[EJ]]></given-names>
</name>
<name>
<surname><![CDATA[Williams]]></surname>
<given-names><![CDATA[SB]]></given-names>
</name>
<name>
<surname><![CDATA[Morrison]]></surname>
<given-names><![CDATA[CC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Screening for thyroid cancer Updated evidence report and systematic review for the US preventive services task force]]></article-title>
<source><![CDATA[JAMA]]></source>
<year>2017</year>
<volume>317</volume>
<numero>18</numero>
<issue>18</issue>
<page-range>1888-903</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[James]]></surname>
<given-names><![CDATA[DL]]></given-names>
</name>
<name>
<surname><![CDATA[Ryan]]></surname>
<given-names><![CDATA[ÉJ]]></given-names>
</name>
<name>
<surname><![CDATA[Davey]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Quinn]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Heath]]></surname>
<given-names><![CDATA[DP]]></given-names>
</name>
<name>
<surname><![CDATA[Garry]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Radioiodine Remnant Ablation for Differentiated Thyroid Cancer A Systematic Review and Meta-analysis]]></article-title>
<source><![CDATA[JAMA Otolaryngol Head Neck Surg]]></source>
<year>2021</year>
<volume>147</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>544-52</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tuttle]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
<name>
<surname><![CDATA[Alzahrani]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk Stratification in Differentiated Thyroid Cancer From Detection to Final Follow-up]]></article-title>
<source><![CDATA[J Clin Endocrinol Metab]]></source>
<year>2019</year>
<volume>104</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>4087-100</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fleeman]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Houten]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Bagust]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Richardson]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Beale]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Boland]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine, Health Technology Assessment]]></article-title>
<source><![CDATA[National Institute for Health and Care Excellence]]></source>
<year>2020</year>
<volume>24</volume>
<page-range>1-28</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Byun]]></surname>
<given-names><![CDATA[BH]]></given-names>
</name>
<name>
<surname><![CDATA[Jeong]]></surname>
<given-names><![CDATA[UG]]></given-names>
</name>
<name>
<surname><![CDATA[Hong]]></surname>
<given-names><![CDATA[SP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prediction of central lymph node metastasis from papillary thyroid microcarcinoma by 18F-fluorodeoxyglucose PET/CT and ultrasonography]]></article-title>
<collab>Jung-Joon Min.Ari Chong.Ho-Chun Song</collab>
<source><![CDATA[Ann Nucl Med]]></source>
<year>2012</year>
<volume>26</volume>
<page-range>471-7</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cho]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
<name>
<surname><![CDATA[Suh]]></surname>
<given-names><![CDATA[CH]]></given-names>
</name>
<name>
<surname><![CDATA[Baek]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Chung]]></surname>
<given-names><![CDATA[SR]]></given-names>
</name>
<name>
<surname><![CDATA[Choi]]></surname>
<given-names><![CDATA[YJ]]></given-names>
</name>
<name>
<surname><![CDATA[Chung]]></surname>
<given-names><![CDATA[KW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Active Surveillance for Small Papillary Thyroid Cancer A Systematic Review and Meta-Analysis]]></article-title>
<source><![CDATA[Thyroid]]></source>
<year>2019</year>
<volume>29</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>1399-408</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Oda]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Miyauchi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ito]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Yoshioka]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Nakayama]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Sasai]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Incidences of Unfavorable Events in the Management of Low-Risk Papillary Microcarcinoma of the Thyroid by Active Surveillance Versus Immediate Surgery]]></article-title>
<source><![CDATA[Thyroid]]></source>
<year>2016</year>
<volume>26</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>150-5</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Filetti]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Durante]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Hartl]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Leboulleux]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Locati]]></surname>
<given-names><![CDATA[LD]]></given-names>
</name>
<name>
<surname><![CDATA[Newbold]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thyroid cancer ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up]]></article-title>
<source><![CDATA[Annals of Oncology]]></source>
<year>2019</year>
<volume>30</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1856-83</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Russ]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Bonnema]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
<name>
<surname><![CDATA[Erdogan]]></surname>
<given-names><![CDATA[MF]]></given-names>
</name>
<name>
<surname><![CDATA[Durante]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Ngu]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Leenhardt]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[European Thyroid Association Guidelines for Ultrasound Malignancy Risk Stratification of Thyroid Nodules in Adults The EU-TIRADS]]></article-title>
<source><![CDATA[Eur Thyroid J]]></source>
<year>2017</year>
<volume>6</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>225-37</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mauri]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Hegedüs]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Bandula]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Cazzato]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
<name>
<surname><![CDATA[Czarniecka]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Dudeck]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[European Thyroid Association and Cardiovascular and Interventional Radiological Society of Europe 2021 Clinical Practice Guideline for the Use of Minimally Invasive Treatments in Malignant Thyroid Lesions]]></article-title>
<source><![CDATA[Eur Thyroid J]]></source>
<year>2021</year>
<volume>10</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>185-97</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Amin]]></surname>
<given-names><![CDATA[MB]]></given-names>
</name>
<name>
<surname><![CDATA[Greene]]></surname>
<given-names><![CDATA[FL]]></given-names>
</name>
<name>
<surname><![CDATA[Edge]]></surname>
<given-names><![CDATA[SB]]></given-names>
</name>
<name>
<surname><![CDATA[Compton]]></surname>
<given-names><![CDATA[CC]]></given-names>
</name>
<name>
<surname><![CDATA[Gershenwald]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[Brookland]]></surname>
<given-names><![CDATA[RK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Eighth Edition AJCC Cancer Staging Manual Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging]]></article-title>
<source><![CDATA[CA Cancer J Clin]]></source>
<year>2017</year>
<volume>67</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>93-9</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pacini]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Fuhrer]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Elisei]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Handkiewicz-Junak]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Leboulleux]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Luster]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[2022 ETA Consensus Statement: What are the indications for post-surgical radioiodine therapy in differentiated thyroid cancer?]]></article-title>
<source><![CDATA[Eur Thyroid J]]></source>
<year>2022</year>
<volume>11</volume>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tessler]]></surname>
<given-names><![CDATA[FN]]></given-names>
</name>
<name>
<surname><![CDATA[Middleton]]></surname>
<given-names><![CDATA[WD]]></given-names>
</name>
<name>
<surname><![CDATA[Grant]]></surname>
<given-names><![CDATA[EG]]></given-names>
</name>
<name>
<surname><![CDATA[Hoang]]></surname>
<given-names><![CDATA[JK]]></given-names>
</name>
<name>
<surname><![CDATA[Berland]]></surname>
<given-names><![CDATA[LL]]></given-names>
</name>
<name>
<surname><![CDATA[Teefey]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[ACR Thyroid Imaging, Reporting and Data System (TI-RADS) White Paper of the ACR TI-RADS Committee]]></article-title>
<source><![CDATA[Journal of the American College of Radiology]]></source>
<year>2017</year>
<volume>14</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>587-95</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sanabria]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Rigau]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Rotaeche]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Selva]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Marzo-Castillejo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Alonso-Coello]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Sistema GRADE Metodología para la realización de recomendaciones para la práctica clínica]]></article-title>
<source><![CDATA[Aten Primaria]]></source>
<year>2015</year>
<volume>47</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>48-55</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Haugen]]></surname>
<given-names><![CDATA[BR]]></given-names>
</name>
<name>
<surname><![CDATA[Alexander]]></surname>
<given-names><![CDATA[EK]]></given-names>
</name>
<name>
<surname><![CDATA[Bible]]></surname>
<given-names><![CDATA[KC]]></given-names>
</name>
<name>
<surname><![CDATA[Doherty]]></surname>
<given-names><![CDATA[GM]]></given-names>
</name>
<name>
<surname><![CDATA[Mandel]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
<name>
<surname><![CDATA[Nikiforov]]></surname>
<given-names><![CDATA[YE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer]]></article-title>
<source><![CDATA[Thyroid]]></source>
<year>2016</year>
<volume>26</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>1-133</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="">
<collab>National Institute for Health and Care Excellence</collab>
<source><![CDATA[Thyroid cancer: assessment and management NICE guideline]]></source>
<year>2022</year>
<page-range>1-56</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Miyauchi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ito]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Fujishima]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Miya]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Onoda]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Kihara]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Long-term outcomes of active surveillance and immediate surgery for adult patients with low-risk papillary thyroid microcarcinoma 30-year experience]]></article-title>
<source><![CDATA[Thyroid]]></source>
<year>2023</year>
<volume>33</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>817-25</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Zhao]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Xia]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Cao]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Zhao]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Active surveillance of highly suspicious thyroid nodules cohort in China shows a worse psychological status in younger patients]]></article-title>
<source><![CDATA[Front Oncol]]></source>
<year>2022</year>
</nlm-citation>
</ref>
<ref id="B23">
<label>24</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sanabria]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Active Surveillance in Thyroid Microcarcinoma in a Latin-American Cohort]]></article-title>
<source><![CDATA[JAMA Otolaryngology - Head and Neck Surgery]]></source>
<year>2018</year>
<volume>144</volume>
<page-range>947-8</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Koshkina]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Fazelzad]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Sugitani]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Miyauchi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Thabane]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Goldstein]]></surname>
<given-names><![CDATA[DP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Association of Patient Age with Progression of Low-risk Papillary Thyroid Carcinoma under Active Surveillance A Systematic Review and Meta-analysis]]></article-title>
<source><![CDATA[JAMA Otolaryngol Head Neck Surg]]></source>
<year>2020</year>
<volume>146</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>552-60</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>26</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tuttle]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
<name>
<surname><![CDATA[Fagin]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Minkowitz]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Wong]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<name>
<surname><![CDATA[Roman]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Patel]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Natural history and tumor volume kinetics of papillary thyroid cancers during active surveillance]]></article-title>
<source><![CDATA[JAMA Otolaryngol Head Neck Surg]]></source>
<year>2017</year>
<volume>143</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>1015-20</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>27</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Perros]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Boelaert]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Colley]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Evans]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Evans]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
<name>
<surname><![CDATA[Gerrard Ba]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Guidelines for the management of thyroid cancer]]></article-title>
<source><![CDATA[Clin Endocrinol (Oxf)]]></source>
<year>2014</year>
<volume>81</volume>
<numero>^sSUPPL. 1</numero>
<issue>^sSUPPL. 1</issue>
<supplement>SUPPL. 1</supplement>
<page-range>1-122</page-range></nlm-citation>
</ref>
<ref id="B27">
<label>28</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Campopiano]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Matrone]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Rago]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Scutari]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Prete]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Agate]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Assessing mPTC progression during active surveillance: ¿volume or diameter increase]]></article-title>
<source><![CDATA[J Clin Med.]]></source>
<year>2021</year>
<volume>10</volume>
<numero>18</numero>
<issue>18</issue>
</nlm-citation>
</ref>
<ref id="B28">
<label>30</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Parvathareddy]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
<name>
<surname><![CDATA[Siraj]]></surname>
<given-names><![CDATA[AK]]></given-names>
</name>
<name>
<surname><![CDATA[Iqbal]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Qadri]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Ahmed]]></surname>
<given-names><![CDATA[SO]]></given-names>
</name>
<name>
<surname><![CDATA[Al-Rasheed]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[TERT Promoter Mutations Are an Independent Predictor of Distant Metastasis in Middle Eastern Papillary Thyroid Microcarcinoma]]></article-title>
<source><![CDATA[Front Endocrinol (Lausanne)]]></source>
<year>2022</year>
<volume>13</volume>
<page-range>808298</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
