The Initial Risk Stratification System for Differentiated Thyroid Cancer: Key Updates in the 2024 Korean Thyroid Association Guideline
In 2024, the Korean Thyroid Association (KTA) introduced a revised Risk Stratification System (K-RSS) for differentiated thyroid cancer, building upon the modified RSS (M-RSS) proposed by the American Thyroid Association in 2015. The K-RSS emphasizes the cumulative impact of coexisting clinical and...
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Korean Endocrine Society
2025-06-01
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| Series: | Endocrinology and Metabolism |
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| Online Access: | http://www.e-enm.org/upload/pdf/enm-2025-2465.pdf |
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| author | Shinje Moon Young Shin Song Kyong Yeun Jung Eun Kyung Lee Jeongmin Lee Dong-Jun Lim Chan Kwon Jung Young Joo Park on Behalf of the Korean Thyroid Association Clinical Guideline Committee |
| author_facet | Shinje Moon Young Shin Song Kyong Yeun Jung Eun Kyung Lee Jeongmin Lee Dong-Jun Lim Chan Kwon Jung Young Joo Park on Behalf of the Korean Thyroid Association Clinical Guideline Committee |
| author_sort | Shinje Moon |
| collection | DOAJ |
| description | In 2024, the Korean Thyroid Association (KTA) introduced a revised Risk Stratification System (K-RSS) for differentiated thyroid cancer, building upon the modified RSS (M-RSS) proposed by the American Thyroid Association in 2015. The K-RSS emphasizes the cumulative impact of coexisting clinical and pathological features, acknowledging that multiple intermediate-risk factors collectively indicate a higher recurrence risk. Histologic classification follows the 2022 World Health Organization classification, consolidating encapsulated follicular-patterned thyroid carcinomas, including invasive encapsulated follicular variant papillary thyroid carcinoma, follicular thyroid carcinoma, and oncocytic carcinoma of the thyroid gland, and stratifying them by the extent of capsular and vascular invasion. High-grade thyroid carcinoma is newly included. Updated criteria for tumor size and extrathyroidal extension (ETE) represent another significant change. BRAFV600E-mutated papillary thyroid carcinomas measuring 1 to 2 cm are now considered lower risk than previously classified in the M-RSS, while encapsulated follicular-patterned tumors larger than 4 cm are considered higher risk. Both minimal ETE and gross ETE confined to the strap muscles have been downgraded to low and intermediate risk, respectively. These changes are accompanied by updates regarding molecular profiling and surgical margin status. Collectively, these updates aim to minimize overtreatment in low-risk patients, while ensuring intensified management for those at higher risk. |
| format | Article |
| id | doaj-art-728b4dc0faf14dc4ace7ba9671db2e77 |
| institution | Kabale University |
| issn | 2093-596X 2093-5978 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Korean Endocrine Society |
| record_format | Article |
| series | Endocrinology and Metabolism |
| spelling | doaj-art-728b4dc0faf14dc4ace7ba9671db2e772025-08-20T03:29:09ZengKorean Endocrine SocietyEndocrinology and Metabolism2093-596X2093-59782025-06-0140335738410.3803/EnM.2025.24652625The Initial Risk Stratification System for Differentiated Thyroid Cancer: Key Updates in the 2024 Korean Thyroid Association GuidelineShinje Moon0Young Shin Song1Kyong Yeun Jung2Eun Kyung Lee3Jeongmin Lee4Dong-Jun Lim5Chan Kwon Jung6Young Joo Park7on Behalf of the Korean Thyroid Association Clinical Guideline Committee Department of Internal Medicine, Hanyang University Seoul Hospital, Seoul, Korea Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Korea Department of Internal Medicine, National Cancer Center, Goyang, Korea Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea Department of Internal Medicine, Seoul National University College of Medicine, Seoul, KoreaIn 2024, the Korean Thyroid Association (KTA) introduced a revised Risk Stratification System (K-RSS) for differentiated thyroid cancer, building upon the modified RSS (M-RSS) proposed by the American Thyroid Association in 2015. The K-RSS emphasizes the cumulative impact of coexisting clinical and pathological features, acknowledging that multiple intermediate-risk factors collectively indicate a higher recurrence risk. Histologic classification follows the 2022 World Health Organization classification, consolidating encapsulated follicular-patterned thyroid carcinomas, including invasive encapsulated follicular variant papillary thyroid carcinoma, follicular thyroid carcinoma, and oncocytic carcinoma of the thyroid gland, and stratifying them by the extent of capsular and vascular invasion. High-grade thyroid carcinoma is newly included. Updated criteria for tumor size and extrathyroidal extension (ETE) represent another significant change. BRAFV600E-mutated papillary thyroid carcinomas measuring 1 to 2 cm are now considered lower risk than previously classified in the M-RSS, while encapsulated follicular-patterned tumors larger than 4 cm are considered higher risk. Both minimal ETE and gross ETE confined to the strap muscles have been downgraded to low and intermediate risk, respectively. These changes are accompanied by updates regarding molecular profiling and surgical margin status. Collectively, these updates aim to minimize overtreatment in low-risk patients, while ensuring intensified management for those at higher risk.http://www.e-enm.org/upload/pdf/enm-2025-2465.pdfdifferentiated thyroid cancerrisk assessmentprognosisrecurrenceguidelinekorean |
| spellingShingle | Shinje Moon Young Shin Song Kyong Yeun Jung Eun Kyung Lee Jeongmin Lee Dong-Jun Lim Chan Kwon Jung Young Joo Park on Behalf of the Korean Thyroid Association Clinical Guideline Committee The Initial Risk Stratification System for Differentiated Thyroid Cancer: Key Updates in the 2024 Korean Thyroid Association Guideline Endocrinology and Metabolism differentiated thyroid cancer risk assessment prognosis recurrence guideline korean |
| title | The Initial Risk Stratification System for Differentiated Thyroid Cancer: Key Updates in the 2024 Korean Thyroid Association Guideline |
| title_full | The Initial Risk Stratification System for Differentiated Thyroid Cancer: Key Updates in the 2024 Korean Thyroid Association Guideline |
| title_fullStr | The Initial Risk Stratification System for Differentiated Thyroid Cancer: Key Updates in the 2024 Korean Thyroid Association Guideline |
| title_full_unstemmed | The Initial Risk Stratification System for Differentiated Thyroid Cancer: Key Updates in the 2024 Korean Thyroid Association Guideline |
| title_short | The Initial Risk Stratification System for Differentiated Thyroid Cancer: Key Updates in the 2024 Korean Thyroid Association Guideline |
| title_sort | initial risk stratification system for differentiated thyroid cancer key updates in the 2024 korean thyroid association guideline |
| topic | differentiated thyroid cancer risk assessment prognosis recurrence guideline korean |
| url | http://www.e-enm.org/upload/pdf/enm-2025-2465.pdf |
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