Endocrinol Metab.  2021 Aug;36(4):717-724. 10.3803/EnM.2021.1042.

Active Surveillance as an Effective Management Option for Low-Risk Papillary Thyroid Microcarcinoma

• Jeon MJ
• Kim WG
• Kim TY
• Shong YK
• Kim WB

• KMID: 2519659
• DOI: http://doi.org/10.3803/EnM.2021.1042

Abstract

Active surveillance (AS) for low-risk papillary thyroid microcarcinoma (PTMC) has been accepted worldwide as safe and effective. Despite the growing acceptance of AS in the management of low-risk PTMCs, there are barriers to AS in real clinical settings, and it is important to understand and establish appropriate AS protocol from initial evaluation to follow-up. PTMC management strategies should be decided upon after careful consideration of patient and tumor characteristics by a multidisciplinary team of thyroid cancer specialists. Patients should understand the risks and benefits of AS, participate in decision-making and follow structured monitoring strategies. In this review, we discuss clinical outcomes of AS from previous studies, optimal indications and follow-up strategies for AS, and unresolved questions about AS.

Keyword

Thyroid neoplasms; Papillary thyroid microcarcinoma; Watchful waiting

Figure

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  Fig. 1 Algorithm for assessing patient and tumor characteristics informing the decision to implement active surveillance (AS) of papillary thyroid microcarcinoma. PTMC, papillary thyroid microcarcinoma; ETE, extrathyroidal extension; Y, yes; N, no. aT4a, N1, and M1 disease were defined according to the American Joint Committee on Cancer tumor-node-metastasis staging system.

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