The 2025 American Thyroid Association Guidelines for the Management of Differentiated Thyroid Cancer in Adults, supported centrally by evidence-based medical evidence, has introduced systematic updates to the diagnostic pathways, treatment regimens, and follow-up strategies for thyroid cancer. Its content not only covers multidisciplinary fields such as internal medicine, surgery, radiology, and pathology, but also fully incorporates perspectives from patient populations—further enhancing the alignment of the guidelines with clinical practice and achieving comprehensive coverage of the whole-course management for differentiated thyroid cancer. In the field of surgical management, the guidelines focus primarily on four core areas: the scientific definition of thyroid resection scope, the rational planning of lymph node dissection scope, the precise protection of the recurrent laryngeal nerve, and the whole-course preservation of parathyroid function. For these key aspects, the guideline has put forward specific and guiding recommendations based on rigorous evidence-based medical evidence and multidisciplinary team consensus. This article integrates the expert interpretation findings from the 2024 American Thyroid Association annual meeting, providing a prospective organization and summary of the key clinical practice points and basis for updates in its surgical management chapter.
ObjectiveTo compare the citations of Chinese literature in the 2015 and 2025 editions of the American Thyroid Association (ATA) guidelines, aiming to evaluate the progress in the field of differentiated thyroid cancer (DTC) research in China. MethodsChinese literature cited in the 2015 and 2025 ATA guidelines was collected and cataloged. A comparison was conducted between the two editions regarding the number of publications, source journals, affiliated institutions and their regional distribution, research types, and research foci of the cited literature. Results ① Changes in the quantity and regional distribution of Chinese citations: in the 2025 ATA guideline, the proportion of Chinese literature cited increased by nearly two times compared to the 2015 ATA guideline [8.8% (128/1 458) vs. 3.3% (36/1 078), P＜0.001]. The number of source journals increased by nearly three times (74 vs. 21), the number of contributing cities nearly doubled (29 vs. 13), and the number of involved healthcare institutions increased by nearly three times (65 vs. 18). In terms of regional distribution, compared to the 2015 ATA guideline, where institutions producing cited literature were mainly located in the Taiwan region (11 publications), the Hong Kong region (11 publications), and coastal and Beijing-Tianjin-Hebei rigions of the Chinese mainland (12 publications), the 2025 ATA guideline showed a expansion of distribution to medical centers in regions such as Beijing-Tianjin-Hebei, Yangtze River Delta, Pearl River Delta, Chengdu, and Changchun. Among these, West China Hospital of Sichuan University had the highest number of cited publications nationwide (20 publications). The proportion of cited literature from institutions in the Chinese mainland increased significantly compared to that from the Taiwan and Hong Kong regions [69.2% (45/65) vs. 16.9% (11/65) and 13.8% (9/65)]. ② Changes in research types of cited literature: clinical research constituted the majority [100% (36/36) and 97.7% (125/128), respectively] of the cited Chinese literature in both the 2015 and 2025 ATA guidelines. However, three basic research studies appeared in the 2025 ATA guideline. Cited literature in both editions was predominantly single-center studies [86.7% (26/30) and 93.8% (90/96), respectively]. ③ Changes in research foci of cited literature: the number of research foci involved in the 2025 ATA guideline (19 foci) increased by nearly doubled compared to the 2015 ATA guideline (11 foci). Among them, iodine-131 therapy was the most cited research focus in both editions. Among research foci with ≥5 citations, besides traditional areas such as tumor staging and prognosis, and surgical methods and extent which remained top-ranked, the ranking of recurrent laryngeal nerve protection rose. The ranking of some traditional research foci, such as molecular markers, imaging, preoperative diagnosis, declined. Notable newly prominent or significantly changed foci included ablation therapy (12 publications, ranked 2nd), comprehensive treatment (11 publications), lymph node metastasis (10 publications), parathyroid protection (7 publications), thyroid cancer and pregnancy risks (5 publications), and active surveillance (5 publications). ConclusionsCompared to the 2015 ATA guideline, the 2025 ATA guideline cites a higher proportion of Chinese literature, demonstrates a wider geographical distribution of publication origins (expanding from Taiwan region, Hong Kong region, and coastal developed area to major regional centers across China), and covered broader and more in-depth research foci. This suggests that the field of DTC in China has undergone robust development in recent years, with a gradual shift from traditional focuses such as cure rate and recurrence rate towards improving long-term quality of life, developing individualized, and precise comprehensive management models. China is playing an increasingly important role in establishing global DTC diagnostic and treatment standards. However, high-quality prospective, multicenter, randomized controlled trials remain to be strengthened.