(A575) Management of Well-Differentiated Thyroid Carcinoma Following 2015 ATA Updated Guidelines

Introduction: The 2015 American Thyroid Association (ATA) guidelines describe changes in treatment recommendations for well-differentiated thyroid carcinomas (DTC), including updated criteria for total thyroidectomy, thyroid lobectomy, and radioactive iodine (RAI) treatment. This study aims to determine how the updated ATA guidelines have influenced the management of WDC.

Methods: This was a retrospective study using the TriNetX Research Network. Patients with DTC were identified using ICD-10 and ICD-O codes, and CPT codes were used to identify those who underwent surgical resection or RAI treatment. Patients were separated into cohorts based on year of treatment (before 2015 vs. after 2015), and rates of treatment types were compared between cohorts.

Results: 72,901 patients were included in the analysis. Patients treated after 2015 were 7.76% more likely to undergo thyroid lobectomy and 19.68% less likely to undergo RAI treatment (p < 0.01). These changes were seen in academic and non-academic medical centers, with a greater degree of change among non-academic medical centers (8.53% more likely to undergo thyroid lobectomy and 34.49% less likely to undergo RAI treatment after 2015). A smaller decrease in the rate of RAI treatment was seen in patients aged 55 and older (17.04% difference) compared to patients under 55 (18.44% difference). There was no significant difference in overall survival between patients treated before 2015 and patients treated after 2015.

Conclusions: The 2015 ATA guidelines were successful in influencing treatment patterns in patients with DTC. The increase in thyroid lobectomy and decrease in RAI treatment after 2015 is consistent with the de-escalation of treatment outlined in the guidelines, allowing patients to avoid adverse effects associated with more invasive treatment options while maintaining overall survival rates.