van de Berg, D.J. orcid.org/0000-0003-3670-7422, van Santen, H.M. orcid.org/0000-0002-6773-6931, Clement, S.C. et al. (139 more authors) (2025) International consensus on the requirements for definitions of complete remission and recurrence of differentiated thyroid cancer: a delphi study (ICON-DTC). European Journal of Endocrinology, 193 (6). pp. 772-782. ISSN: 0804-4643
Abstract
Objective
Recurrence is a key outcome measure of treatment for differentiated thyroid carcinoma (DTC). In international guidelines and current literature, a consistent definition is lacking, which hinders comparison of treatment-related oncological outcomes. Therefore, the aim of this study was to reach international consensus among experts from all medical specialties involved in the care of patients with DTC on the essential elements minimally required for a universal definition of recurrence—serving as a first step toward developing a new, universally accepted definition of DTC recurrence.
Design
We conducted an international Delphi study.
Methods
A steering committee provided advice on the study protocol and Delphi rounds. Experts were identified through various scientific associations, international guidelines, ClinicalTrials.gov, our systematic review on definitions of DTC recurrence, and suggestions from the steering committee. A 3-round Delphi process was conducted to reach consensus on the minimally essential components of the definition of DTC recurrence. The initial list of components was derived from our systematic review.
Results
In total, 127 experts from all medical specialties involved in the diagnosis and treatment of DTC, representing 35 countries across 4 continents, completed 3 Delphi rounds. Thirteen key components critical for defining complete remission and recurrence of DTC were identified, following treatment with total thyroidectomy and postoperative radioiodine therapy (RIT), total thyroidectomy without RIT, and less-than-total thyroidectomy.
Conclusions
The components identified through this international Delphi consensus can serve as the foundation for the further development of universal definitions of DTC recurrence.
Metadata
| Item Type: | Article |
|---|---|
| Authors/Creators: |
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| Copyright, Publisher and Additional Information: | © The Author(s) 2025. Published by Oxford University Press on behalf of European Society of Endocrinology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. |
| Keywords: | complete remission; definitions; differentiated thyroid cancer; recurrence; Humans; Thyroid Neoplasms; Delphi Technique; Neoplasm Recurrence, Local; Consensus; Thyroidectomy; Remission Induction; Iodine Radioisotopes |
| Dates: |
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| Institution: | The University of Sheffield |
| Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health |
| Date Deposited: | 21 Jan 2026 17:07 |
| Last Modified: | 21 Jan 2026 17:07 |
| Status: | Published |
| Publisher: | Oxford University Press (OUP) |
| Refereed: | Yes |
| Identification Number: | 10.1093/ejendo/lvaf243 |
| Related URLs: | |
| Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:236768 |
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