Argentine intersociety Delphi consensus on the diagnosis, treatment, and follow-up of differentiated thyroid carcinoma: FASEN | SAEM | AACCYC | AABYMN | AAOC

Abstract

Differentiated thyroid carcinoma (DTC) has shown a sustained worldwide increase in incidence, with low disease-specific mortality, which has driven an increasingly individualized approach. The aim of this study was to develop a national intersocietal Delphi consensus to formulate clinical recommendations on the evaluation, treatment, and follow-up of DTC, tailored to the local context. Materials and methods: we conducted a consensus study using a modified Delphi methodology. An interdisciplinary expert panel appointed by FASEN, SAEM, AACCyC, AABYMN, and AAOC assessed clinical statements organized into thematic domains spanning the entire DTC care continuum. Each statement was rated on a 9-point Likert scale. A priori consensus criteria were defined based on the median, interquartile range (IQR), and the proportion of ratings in the 7-9 range. Items not reaching consensus were re-evaluated in subsequent rounds. Results: a total of 196 statements were evaluated across 13 thematic domains. In the final analysis, overall consensus was achieved in 99.5% of the items. The highest levels of agreement were observed in initial evaluation, standardization of the pathology report, risk stratification (initial and dynamic), indications and preparation for radioiodine therapy, and response-guided follow-up. The item with the lowest level of agreement concerned the use of low-activity diagnostic ¹³¹I scanning prior to therapy in intermediate- and high-risk patients, reflecting the need for clinical individualization and adaptation to the local context. Conclusions: this intersocietal consensus provides structured, context-specific clinical recommendations for comprehensive DTC management. It also offers a framework to support clinical decision-making in heterogeneous scenarios and delineates priorities for research and future updates.