A Protocol for a Pan-Canadian Prospective Observational Study on Active Surveillance or Surgery for Very Low Risk...

Area of Science:

• Endocrinology
• Oncology
• Surgical Oncology

Background:

• Papillary thyroid cancer (PTC) is traditionally managed with thyroidectomy.
• Active surveillance (AS) is an alternative for small, low-risk PTC, involving close monitoring and intervention if disease progresses.
• AS requires regular clinical and radiological assessments.

Purpose of the Study:

• To compare the disease management outcomes of active surveillance (AS) versus immediate surgery for small, low-risk papillary thyroid cancer (PTC).
• To assess long-term oncologic outcomes and patient-reported outcomes in patients with PTC.
• To inform future clinical trial designs for PTC management.

Main Methods:

• Prospective, observational, multi-centre Canadian cohort study.
• Adult patients with small (<2cm), low-risk PTC were offered a choice between AS or surgery.
• Disease management was patient-selected, not investigator-assigned.
• Primary objective: determine the rate of 'failure' (progression requiring surgery for AS, or persistence/progression post-initial treatment for surgery).

Main Results:

• This section is not available in the provided abstract.
• Further analysis is required to determine the rate of disease management failure in both arms.
• Long-term oncologic and patient-reported outcomes will be collected and analyzed.

Conclusions:

• The study will provide crucial long-term evidence on AS versus surgery for small, low-risk PTC.
• Findings will guide clinical decision-making and future research in PTC management.
• Patient choice in management strategy is a key aspect of this observational study.