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Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers, Part II: Follow-up Surveillance after Initial Treatment 2026

In brief

Korean guideline tailors TSH and thyroglobulin targets to ongoing risk stratification

The 2026 Korean Thyroid Association recommendations extend the 2024 guidance by urging clinicians to use continuous risk assessment to set individualized serum TSH goals and thyroglobulin thresholds, and to adjust follow-up intervals according to both initial risk and treatment response. This risk-adapted approach aims to spare low-risk patients from unnecessary testing while flagging those who need closer surveillance, though real-world impact on outcomes remains to be studied.

Journal
Endocrinology and metabolism (Seoul, Korea) (Q1)
Published
31 August 2026
Study design
Practice guideline / consensus
Evidence level
Level 1, High (CEBM 1c)
Authors
Eun Kyung Lee, Seung Heon Kang, Bon Seok Koo, Mijin Kim, Min Joo Kim, Bo Hyun Kim, et al.
PMID
42705671
DOI
10.3803/EnM.2026.3149

Why clinicians should know about it

Abstract

In patients with differentiated thyroid cancer, initial recurrence-risk stratification based on clinical, histopathological, and perioperative findings remains central to management during the first 1-2 years after initial treatment. Ongoing risk stratification (ORS) complements this initial assessment by continuously integrating longitudinal clinical data and treatment response, thereby refining long-term prognostic assessment and supporting individualized risk-adapted management. Building on the 2024 Korean Thyroid Association (KTA) guidelines, the 2026 KTA guideline incorporates new evidence from large Korean multicenter cohorts and comprehensive systematic reviews. The updated recommendations reinforce the continued application of ORS and provide more specific guidance on risk-adapted thyroid-stimulating hormone (TSH) targets, surveillance strategies for recurrence detection, and long-term follow-up tailored to individual recurrence risk and treatment response. Consistent with the evolving paradigm toward risk-adapted and individualized management, this revision updates recommendations regarding target serum TSH levels, serum thyroglobulin thresholds for response assessment and long-term surveillance, and follow-up intervals based on both initial-risk category and the ORS response category. These evidence-based recommendations aim to minimize unnecessary treatment and excessive surveillance in the majority of patients who have an excellent prognosis after initial therapy while ensuring individualized long-term management for patients who require closer surveillance or additional therapeutic intervention.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.