{"entity":{"id":"paper-estimabl2-leboulleux-nejm-2022","kind":"paper","name":"ESTIMABL2: thyroidectomy without radioiodine in patients with low-risk thyroid cancer","aka":[],"tldr":"Skipping radioactive iodine after thyroidectomy for low-risk differentiated thyroid cancer gave the same excellent three-year outcomes as giving it, so most low-risk patients can avoid the treatment.","summary":"Phase 3 non-inferiority trial of 776 patients with low-risk differentiated thyroid cancer (pT1a multifocal to pT1b, N0 or Nx) randomised after total thyroidectomy to postoperative radioiodine (1.1 GBq) or no radioiodine.\n\nAt three years, 95.6 percent of the no-radioiodine group and 95.9 percent of the radioiodine group had no event (abnormal imaging, thyroglobulin rise or further treatment), meeting non-inferiority, with no differences in quality of life or adverse events.","asOf":"2026-09-17","links":[{"label":"N Engl J Med 2022","url":"https://doi.org/10.1056/NEJMoa2111953"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/35263518/"}],"tags":[],"related":[],"cancers":["papillary-thyroid-cancer"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["estimabl2"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":2022,"doi":"10.1056/NEJMoa2111953","pmid":"35263518","authors":"Leboulleux S, Bournaud C, Chougnet CN, et al.","paperType":"rct","findings":["Three-year event-free 95.6 percent (no radioiodine) vs 95.9 percent (radioiodine); non-inferior.","Events were mostly biochemical rather than structural."],"whatItMeans":"Radioactive iodine is no longer recommended routinely for low-risk differentiated thyroid cancer, supported also by the UK IoN trial.","caveats":["Follow-up of three years is short for a disease with late recurrences.","Applies to low-risk tumours up to 2 cm without nodal disease."],"changedPractice":true,"participants":776},"route":"/key-papers/paper-estimabl2-leboulleux-nejm-2022/","neighbours":{"cancer":[{"id":"papillary-thyroid-cancer","kind":"cancer","name":"Papillary thyroid cancer","route":"/cancers/papillary-thyroid-cancer/"}],"trial":[{"id":"estimabl2","kind":"trial","name":"ESTIMABL2","route":"/trials/estimabl2/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}