Ramifications of New Terminology for Encapsulated Follicular Variant of Papillary Thyroid Carcinoma

To the Editor I read with interest the article by Nikiforov et al.¹ However, I have certain queries on this interesting article. The criteria for following up the patients who were in group 1 and had noninvasive encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC) are not clear. In patients who undergo total thyroidectomy (TT), to declare them as disease free we perform a thyroglobulin/radioiodine (RAI) uptake scan. In this group with noninvasive EFVPTC, neither RAI nor thyroglobulin is helpful because they are patients who underwent hemithyroidectomy (HT). Then what were the criteria used to declare them disease free? It is well known that these tumors, even if metastatic, have an indolent course and prolonged survival. The criteria used to label them free of local disease and asymptomatic distant disease have to be mentioned.