Active Surveillance for Patients With Papillary Thyroid Microcarcinoma: A Single Center's Experience in Korea
- 31 May 2017
- journal article
- research article
- Published by The Endocrine Society in Journal of Clinical Endocrinology & Metabolism
- Vol. 102 (6), 1917-1925
- https://doi.org/10.1210/jc.2016-4026
Abstract
Context: Papillary thyroid microcarcinoma (PTMC) usually has an excellent prognosis. Objective: To evaluate the three-dimensional structures of PTMCs, using serial neck ultrasonography (US) in patients under active surveillance. Design and Setting: A retrospective cohort study. Participants: In total, 192 patients diagnosed with PTMC under active surveillance for >1 year were included in a median 30-month follow-up. Changes in tumor size were evaluated not only using the maximal tumor diameter but also the tumor volume. Results: The median age of patients was 51.3 years and 145 patients (76%) were female. The median initial maximal tumor diameter and tumor volume were 5.5 mm and 48.8 mm(3), respectively. The tumor size increased in 27 patients (14%); 23 patients showed a tumor volume increase >50% without a maximal diameter increase of >= 3 mm. The other four patients had both an increasing tumor volume and increasing maximal tumor diameter >= 3 mm. One patient (0.5%) had newly appeared cervical lymph node (LN) metastasis at 3 years after the initial diagnosis. There were no significant risk factors associated with increased tumor size, such as age, sex, or Hashimoto thyroiditis. Twenty-four patients (13%) underwent delayed thyroid surgery at a median of 31.2 months and seven (29%) had cervical LN metastasis on pathologic examination. Conclusion: Some PTMCs could grow significantly after a relatively short period of active surveillance. We alsofound that the change in tumor volume was more sensitive to detect tumor progression than the change in the maximal tumor diameter.This publication has 37 references indexed in Scilit:
- Vanishing Thyroid Tumors: A Diagnostic Dilemma After Ultrasonography-Guided Fine-Needle AspirationThyroid®, 2013
- Should All Papillary Thyroid Microcarcinomas Be Aggressively Treated?Annals of Surgery, 2011
- Clinical Outcomes of Patients with Papillary Thyroid Carcinoma after the Detection of Distant RecurrenceWorld Journal of Surgery, 2010
- Are the Clinical and Pathological Features of Differentiated Thyroid Carcinoma Really Changed over the Last 35 Years? Study on 4187 Patients from a Single Italian Institution to Answer this QuestionJournal of Clinical Endocrinology & Metabolism, 2010
- Three Distinctly Different Kinds of Papillary Thyroid Microcarcinoma should be Recognized: Our Treatment Strategies and OutcomesWorld Journal of Surgery, 2010
- Revised Korean Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Thyroid CancerEndocrinology and Metabolism, 2010
- The Bethesda System for Reporting Thyroid CytopathologyAmerican Journal of Clinical Pathology, 2009
- Recurrence After Treatment of Micropapillary Thyroid CancerThyroid®, 2009
- Increasing Incidence of Thyroid Cancer in the United States, 1973-2002JAMA, 2006
- Changing Trends of Incidence and Prognosis of Thyroid Carcinoma in Lower Franconia, Germany, from 1981–1995Thyroid®, 2004