Long-Term Outcomes of Active Surveillance and Immediate Surgery for Adult Patients with Low-Risk Papillary Thyroid Microcarcinoma: 30-Year Experience
Authors' conclusion
Long-term oncological outcomes of patients with PTMC generally did not differ clinically significantly between those undergoing AS and IS.
Study context
- Population
- Adults with low-risk papillary thyroid microcarcinoma (PTMC) diagnosed at Kuma Hospital, Japan, 1993–2019
- Participants
- 5,646 adults
- Exposure
- Active surveillance vs immediate surgery
- Active surveillance (AS)n = 3,222
- Immediate surgery (IS)n = 2,424reference
- Outcome
- Lymph node metastasis
- Follow-up
- 10 and 20 years
Methodological detailssingle-centre, extended follow-up, Follow-up at least once per year, Descriptive outcome data by treatment group
- Single-centre
- Extended follow-up
- Follow-up at least once per year
- Descriptive outcome data by treatment group
Main finding
As reported in the abstract
AS
1.1% at 10 years; 1.7% at 20 years
IS
0.4% at 10 years; 0.7% at 20 years
P = 0.009
Observational data: associations, not effects.
Further findings
| Outcome | AS | IS | P value |
|---|---|---|---|
| Patients undergoing ≥1 and ≥2 surgeriesSignificantly higher with IS | 12.3% (≥1); 0.09% (≥2) | 100% (≥1); 1.07% (≥2) | P < 0.01 |
- AS: tumour enlargement ≥3 mm
- 3.8% · 124 of 3222
- AS: novel lymph node metastases
- 0.8% · 27 of 3222
- IS: postoperative lymph node recurrence
- 0.5% · 13 of 2424
Recurrence in residual thyroid after hemithyroidectomy
- Recurrence in residual thyroid among 1327 hemithyroidectomy patients
- 18 (1.4%)
Distant metastatic recurrence
Patient
- Distant metastatic recurrence after AS and conversion surgery; both alive (18.4 years after diagnosis)
- 1
- Distant metastatic recurrence after IS; alive (18.8 years after diagnosis)
- 1
Death from thyroid carcinoma
- Deaths from thyroid carcinoma
- 0
Original publication
Long-Term Outcomes of Active Surveillance and Immediate Surgery for Adult Patients with Low-Risk Papillary Thyroid Microcarcinoma: 30-Year Experience. Thyroid. Published 29 May 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →