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Eyun Song Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Republic of Korea

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Dong Eun Song Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Republic of Korea

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Jonghwa Ahn Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Republic of Korea

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Tae Yong Kim Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Republic of Korea

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Won Bae Kim Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Republic of Korea

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Young Kee Shong Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Republic of Korea

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Min Ji Jeon Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Republic of Korea

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Won Gu Kim Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Republic of Korea

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include 53% of patients with distant metastasis ( Ibrahimpasic et al. 2017 ). Since then, to the best of our knowledge, research has not been performed using a similar approach regarding these aggressive forms of thyroid cancer, especially regarding

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Valdemar Máximo i3S Instituto de Investigação e Inovação em Saúde, Porto, Portugal
Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal
Department of Pathology and Oncology, Medical Faculty, University of Porto, Porto, Portugal

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Miguel Melo i3S Instituto de Investigação e Inovação em Saúde, Porto, Portugal
Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal
Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar e Universitário de Coimbra, Medical Faculty, University of Coimbra, Coimbra, Portugal

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Yingjie Zhu Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, USA

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Andrea Gazzo Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, USA

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Manuel Sobrinho Simões i3S Instituto de Investigação e Inovação em Saúde, Porto, Portugal
Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal
Department of Pathology and Oncology, Medical Faculty, University of Porto, Porto, Portugal
Department of Pathology, Hospital São João, Porto 4200-319, Portugal

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Arnaud Da Cruz Paula i3S Instituto de Investigação e Inovação em Saúde, Porto, Portugal
Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal

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Paula Soares i3S Instituto de Investigação e Inovação em Saúde, Porto, Portugal
Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal
Department of Pathology and Oncology, Medical Faculty, University of Porto, Porto, Portugal

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distant metastasis . Cancer Science 111 2163 – 2173 . ( https://doi.org/10.1111/cas.14389 ) Landa I Ibrahimpasic T Boucai L Sinha R Knauf JA Shah RH Dogen S Ricarte-Filho JC Krishnamoorthy GP Xu B , et al. 2016 Genomic and

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Kyungmin Lee Biotherapeutics Translational Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon, Republic of Korea
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, Daejeon, Republic of Korea

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Sang-Hyun Lee Biotherapeutics Translational Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon, Republic of Korea

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Wooil Kim Biotherapeutics Translational Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon, Republic of Korea
Department of Biomolecular Science, KRIBB School of Bioscience, Korea University of Science & Technology, Daejeon, Republic of Korea

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Jangwook Lee Biotherapeutics Translational Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon, Republic of Korea

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Jong-Gil Park Biotherapeutics Translational Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon, Republic of Korea

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Jang-Seong Kim Biotherapeutics Translational Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon, Republic of Korea

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Jung Tae Kim Department of Medical Science, College of Medicine, Chungnam National University, Daejeon, Republic of Korea

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Yea Eun Kang Department of Endocrinology and Metabolism, College of Medicine, Chungnam National University, Daejeon, Republic of Korea

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Minho Shong Department of Internal Medicine, Chungnam National University, School of Medicine, Daejeon, Republic of Korea

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Hyo Jin Lee Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon, Republic of Korea

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Jin-Man Kim Department of Pathology, College of Medicine, Chungnam National University, Daejeon, Republic of Korea

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Won Gu Kim Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

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Bon Seok Koo Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Chungnam National University, Daejeon, Republic of Korea

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Koon Soon Kim Department of Endocrinology and Metabolism, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
Daejeon Endo Internal Medicine, Daejeon, Republic of Korea

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Jeong-Ki Min Biotherapeutics Translational Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Daejeon, Republic of Korea
Department of Biomolecular Science, KRIBB School of Bioscience, Korea University of Science & Technology, Daejeon, Republic of Korea

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tumor invasion or distant metastasis in most ATC patients at the time of diagnosis. Thus, ATC has a poor prognosis, with a mean survival of 4–12 months from the time of diagnosis ( Granata et al. 2013 ). In such advanced cases, initial ATC treatment is

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Henry Crayton Department of Endocrine Surgery, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales, Australia
Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia

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Katherine Wu Department of Endocrinology, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales, Australia

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David Leong Department of Endocrine Surgery, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales, Australia

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Nazim Bhimani The Kinghorn Cancer Centre, Garvan Institute of Medical Research, St. Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Darlinghurst, New South Wales, Australia

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Matti Gild Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
Department of Endocrinology, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales, Australia

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Anthony Glover Department of Endocrine Surgery, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, New South Wales, Australia
Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
The Kinghorn Cancer Centre, Garvan Institute of Medical Research, St. Vincent’s Clinical School, Faculty of Medicine, University of New South Wales, Darlinghurst, New South Wales, Australia

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/or metastatic disease at diagnosis, persistence disease, recurrent disease, distant metastasis, DFS (disease-free survival) and DSM. Quality and risk of bias assessment of eligible studies The Newcastle–Ottawa Quality Assessment Form for cohort studies

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Segolene Hescot Department of Nuclear Medicine, Institut Curie, Saint-Cloud, France

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Abir Al Ghuzlan Department of Pathology, Gustave Roussy and Paris Saclay University, Villejuif, France

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Theophraste Henry Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and Paris Saclay University, Villejuif, France

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Hala Sheikh-Alard Department of Pathology, Gustave Roussy and Paris Saclay University, Villejuif, France

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Livia Lamartina Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and Paris Saclay University, Villejuif, France

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Isabelle Borget Department of Biostatistics, Gustave Roussy and Paris Saclay University, Villejuif, France

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Julien Hadoux Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and Paris Saclay University, Villejuif, France

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Eric Baudin Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and Paris Saclay University, Villejuif, France

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Corinne Dupuy UMR 8200 CNRS, Gustave Roussy and Paris Saclay University, Villejuif, France

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Alyaksandr V Nikitski Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

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Yuri E Nikiforov Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

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Martin Schlumberger Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and Paris Saclay University, Villejuif, France

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Marina N Nikiforova Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

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Sophie Leboulleux Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and Paris Saclay University, Villejuif, France
Department of Endocrinology, Hôpitaux Universitaires de Genève, Geneva, Switzerland

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risk groups (MRGs). The risk stratification was based on the associations between molecular alterations and the probability of disease recurrence or distant metastasis and OS ( Xing et al. 2013 , Yip et al. 2015 , 2021 , Haugen et al. 2016

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Hong-Jun Song Department of Nuclear Medicine, Postgraduate Department, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai 200233, China

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Yan-Li Xue Department of Nuclear Medicine, Postgraduate Department, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai 200233, China
Department of Nuclear Medicine, Postgraduate Department, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai 200233, China

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Yan-Hong Xu Department of Nuclear Medicine, Postgraduate Department, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai 200233, China
Department of Nuclear Medicine, Postgraduate Department, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai 200233, China

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Zhong-Ling Qiu Department of Nuclear Medicine, Postgraduate Department, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai 200233, China

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Quan-Yong Luo Department of Nuclear Medicine, Postgraduate Department, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai 200233, China

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mortality in patients with DTC are age over 45 years and the involvement of multiple organs, both are independently associated with cancer mortality ( Ruegemer et al . 1988 ). The common distant metastasis sites (lung and bone) from DTC usually draw

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Huy Gia Vuong Department of Pathology, University of Yamanashi, Chuo, Yamanashi, Japan

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Toru Odate Department of Pathology, University of Yamanashi, Chuo, Yamanashi, Japan

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Hanh T T Ngo Department of Pathology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam

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Thong Quang Pham Department of Pathology, Cho Ray Hospital, Ho Chi Minh City, Vietnam

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Thao T K Tran Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam

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Kunio Mochizuki Department of Pathology, University of Yamanashi, Chuo, Yamanashi, Japan

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Tadao Nakazawa Department of Pathology, University of Yamanashi, Chuo, Yamanashi, Japan

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Ryohei Katoh Department of Pathology, University of Yamanashi, Chuo, Yamanashi, Japan

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Tetsuo Kondo Department of Pathology, University of Yamanashi, Chuo, Yamanashi, Japan

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category in the most recent guidelines ( Wells et al . 2015 ). Several clinicopathological parameters have been reported to be indicators of poor prognosis in MTCs including age, male gender and distant metastasis ( Raue et al . 1993 , Gulben et al

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Hyun Ho Han Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea
Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea

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Baek Gil Kim Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea

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Joo Hyun Lee Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea

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Suki Kang Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea

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Ji Eun Kim Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea

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Nam Hoon Cho Brain Korea 21 Plus Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea
Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea
Severance Biomedical Science Institute (SBSI), Yonsei University College of Medicine, Seoul, South Korea
Global 5-5-10 System Biology, Yonsei University, Seoul, South Korea

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antiestrogen endocrine therapy, increased ANGPT2 level was associated with a significantly decreased probability of distant metastasis-free survival (DMFS) ( Fig. 7A ). For those without endocrine therapy, contrastingly, ANGPT2 level was not associated with

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Clotilde Sparano Nuclear Medicine and Endocrine Oncology, Gustave Roussy, Université Paris Saclay, Villejuif, France
Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence, Florence, Italy

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Yann Godbert Nuclear Medicine, and Thyroid Oncology Department, Institut Bergonié, Bordeaux, France

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Marie Attard Radiology, Gustave Roussy and Université Paris Saclay, Villejuif, France

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Christine Do Cao Endocrinology, Diabetology and Metabolism, CHRU Lille, Lille, France

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Slimane Zerdoud Nuclear medicine, Claudius-Regaud Institute, Oncology University Institute-IUCT-Oncopole, Toulouse, France

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Nathalie Roudaut Department of Endocrinology, University Hospital of Brest, Brest, France

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Charlotte Joly Department of Oncology, Henri-Mondor Hospital, Créteil, France

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Amandine Berdelou Nuclear Medicine and Endocrine Oncology, Gustave Roussy, Université Paris Saclay, Villejuif, France

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Julien Hadoux Nuclear Medicine and Endocrine Oncology, Gustave Roussy, Université Paris Saclay, Villejuif, France

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Livia Lamartina Nuclear Medicine and Endocrine Oncology, Gustave Roussy, Université Paris Saclay, Villejuif, France

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Martin Schlumberger Nuclear Medicine and Endocrine Oncology, Gustave Roussy, Université Paris Saclay, Villejuif, France

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Sophie Leboulleux Nuclear Medicine and Endocrine Oncology, Gustave Roussy, Université Paris Saclay, Villejuif, France

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, advanced disease with distant metastasis showed the worse prognosis, with a 1-year survival odds of 8.2% ( Smallridge et al. 2012 ). The main breakthrough of the last three decades in the treatment of ATC is the use of a dabrafenib–trametinib combination

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Kyoungjune Pak Department of Nuclear Medicine, Department of Internal Medicine, Medical Research Institute
Department of Nuclear Medicine, Department of Internal Medicine, Medical Research Institute

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Seong-Jang Kim Department of Nuclear Medicine, Department of Internal Medicine, Medical Research Institute
Department of Nuclear Medicine, Department of Internal Medicine, Medical Research Institute

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In Joo Kim Department of Nuclear Medicine, Department of Internal Medicine, Medical Research Institute
Department of Nuclear Medicine, Department of Internal Medicine, Medical Research Institute

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Bo Hyun Kim Department of Nuclear Medicine, Department of Internal Medicine, Medical Research Institute
Department of Nuclear Medicine, Department of Internal Medicine, Medical Research Institute

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Sang Soo Kim Department of Nuclear Medicine, Department of Internal Medicine, Medical Research Institute
Department of Nuclear Medicine, Department of Internal Medicine, Medical Research Institute

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Yun Kyung Jeon Department of Nuclear Medicine, Department of Internal Medicine, Medical Research Institute
Department of Nuclear Medicine, Department of Internal Medicine, Medical Research Institute

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& Grab-Duntas 2006 ). Prognostic factors for DTCs are well known. Age, gender, family history, tumor size, multifocality, extrathyroidal extension (EE), tumor subtype, vascular invasion, lymph node (LN) metastasis, distant metastasis, and low or no iodine

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