Evolving management considerations in active surveillance for micropapillary thyroid carcinoma

Current Opinion in Endocrinology, Diabetes, and Obesity
Allen S HoWendy L Sacks

Abstract

To summarize developments on active surveillance for micropapillary thyroid cancers, with a focus on strategies for optimal risk stratification and caveats that currently limit adoption. Observational trials encompassing thousands of active surveillance patients worldwide have increasingly demonstrated the viability of active surveillance for small, low-risk thyroid cancers. Collectively, these data have established that with proper patient selection and strict monitoring, more than 85% of such cases remain indolent no meaningful clinical growth over at least 10 years. Moreover, to date no cases of symptomatic progression or distant metastasis have been reported, and that delayed treatment when needed has not led to unresectable disease or higher risk of complications. Deeper investigation to better predict clinical progression is necessary to improve patient selection, given concerns regarding patient anxiety, age eligibility, and underestimation of true disease extent. Compelling data from ongoing trials support active surveillance as a first-line management option for micropapillary thyroid carcinomas. Proper risk stratification and strict monitoring protocols will be necessary to sustain the excellent results achieved to da...Continue Reading

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Citations

Mar 8, 2019·Current Opinion in Otolaryngology & Head and Neck Surgery·Aleix RoviraRicard Simo
Oct 22, 2019·Current Opinion in Oncology·Evan WalgamaAllen S Ho
Mar 12, 2019·Current Opinion in Otolaryngology & Head and Neck Surgery·Aleix RoviraRicard Simo
Aug 19, 2020·Annals of Surgical Oncology·Allen S HoZachary S Zumsteg
Aug 14, 2019·Thyroid : Official Journal of the American Thyroid Association·Allen S HoZachary S Zumsteg
Sep 19, 2019·Surgery·Bianka Saravana-BawanTodd McMullen
Feb 20, 2021·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Yong-Lian HuXiao-Hong Wu
Jun 13, 2019·Praxis·Thomas M StadlerMartina A Broglie

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