Active Surveillance as First-Line Management of Papillary Microcarcinoma

Annual Review of Medicine
Yasuhiro Ito, Akira Miyauchi

Abstract

Papillary thyroid microcarcinoma (PMC) is defined as papillary thyroid carcinoma ≤10 mm. Active surveillance of PMC without high-risk features, such as clinical node metastasis, distant metastasis, and clinical evidence of significant extrathyroid extension, was initiated in two Japanese hospitals in the mid-1990s. This strategy was incorporated into guidelines in Japan in 2010 and in the United States in 2015. In studies conducted by the two hospitals, most PMCs grew very slowly or did not grow, and none of the patients during active surveillance showed distant metastasis or died of thyroid carcinoma. Furthermore, none of the patients who underwent surgery after progression signs were detected showed significant recurrence. Therefore, we conclude that active surveillance should be the first line in management of low-risk PMC, because it is safer and less costly than immediate surgery. Active surveillance helps in avoiding adverse events of surgery and is an economical strategy.

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Citations

May 1, 2019·Thyroid : Official Journal of the American Thyroid Association·Min Ji JeonWon Bae Kim
Mar 16, 2019·The Journal of Clinical Endocrinology and Metabolism·R Michael Tuttle, Ali S Alzahrani
Feb 11, 2020·Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Métabolisme·Katherine A AraqueJoanna Klubo-Gwiezdzinska
Mar 5, 2020·Laryngoscope Investigative Otolaryngology·Shivangi LohiaLuc G T Morris
Aug 12, 2020·Thyroid : Official Journal of the American Thyroid Association·Laszlo HegedüsR Michael Tuttle
Jan 7, 2020·Expert Review of Endocrinology & Metabolism·Yasuhiro Ito, Akira Miyauchi
Aug 1, 2020·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Shih-Ping ChengChien-Liang Liu
May 23, 2021·Clinical Endocrinology·Rosie SutherlandMatti L Gild
Apr 9, 2021·The Journal of Clinical Endocrinology and Metabolism·Ruicen LiHuairong Tang

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Methods Mentioned

BETA
dissection
prophylactic surgery

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