Active surveillance as a management strategy for papillary thyroid microcarcinoma

Area of Science:

• Oncology
• Endocrinology
• Surgical Oncology

Background:

• Papillary thyroid microcarcinoma (PTMC) is a common thyroid cancer.
• Active surveillance (AS) is a potential management strategy for low-risk PTMC.
• Traditional management involves immediate surgery, which carries risks.

Purpose of the Study:

• To review and introduce active surveillance (AS) as a treatment strategy for low-risk papillary thyroid microcarcinoma (PTMC).
• To discuss selection criteria, follow-up schedules, and patient/clinician considerations for AS in PTMC management.
• To evaluate the effectiveness of AS as an alternative to immediate surgery for selected PTMC patients.

Main Methods:

• Comprehensive review of global reports on AS for low-risk PTMCs.
• Analysis of various guidelines for selecting AS candidates.
• Discussion of essential components for AS implementation, including diagnosis, progression monitoring, and thyrotropin suppression.

Main Results:

• AS is a viable option for carefully selected low-risk PTMC patients.
• Accurate risk assessment and personalized follow-up are crucial for successful AS.
• Key considerations include cytological diagnosis, progression evaluation, thyrotropin suppression, and cost.

Conclusions:

• Appropriate patient selection is paramount for the effectiveness of AS in low-risk PTMC.
• AS can be an effective alternative to immediate surgery, minimizing risks associated with surgical intervention.
• Dynamic monitoring and risk stratification are essential for managing patients undergoing AS for PTMC.