[Surgery of papillary thyroid microcarcinoma]

Area of Science:

• Endocrinology
• Oncology
• Surgical Oncology

Background:

• Global rise in papillary thyroid microcarcinoma (PTMC) incidence.
• PTMC diagnosis and surgical management are evolving.
• Increasing focus on less invasive treatment strategies.

Purpose of the Study:

• To present PTMC diagnosis and surgical therapy.
• To discuss conservative approaches like active surveillance for PTMC.
• To analyze current international guidelines and surveillance data.

Main Methods:

• Review of international PTMC guidelines.
• Analysis of recent publications on PTMC active surveillance.
• Inclusion of data from Japan, Korea, and the USA.

Main Results:

• Thyroid lobectomy is the standard surgical approach for PTMC.
• Active surveillance is included in Japanese guidelines.
• Tumor growth observed in 8-14% of patients over a median of 75 months.
• Younger patients (<40-50 years) show higher rates of tumor growth and nodal metastasis.

Conclusions:

• Active surveillance presents a potential alternative for older PTMC patients.
• Current follow-up durations are insufficient for definitive conclusions.
• Further long-term studies are required to validate active surveillance for PTMC.