Nonoperative, Active Surveillance of Larger Malignant and Suspicious Thyroid Nodules
Authors' conclusion
These data expand consideration of active surveillance of PTC in select patients with intrathyroidal suspected malignancy greater than 1 cm in diameter. Rescue surgery, if required at a later time point, appears effective.
Study context
- Population
- Patients with known or suspected intrathyroidal papillary thyroid cancer (PTC) up to 4 cm (Bethesda 5 or 6 cytology or "suspicious" Afirma molecular test), 2001–2021followed ≥1 year
- Participants
- 69 patients
- Outcome
- Rate of adverse oncologic outcomes (mortality and recurrence) and cumulative incidence of size/volume growth
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Adverse oncologic outcomes and nodule growth · average 55 months
New lymph node or distant metastasis
0 patients
Concern for progression to dedifferentiated cancer on repeat core biopsy 17 years after start
1 patient
Increase in maximum diameter >3 mm
21%
Volume increase ≥50%
25%
Observational data: associations, not effects.
Further findings
Delayed (rescue) surgery
- Underwent delayed (rescue) surgery
- 13 patients
- Disease recurrence after rescue surgery
- 0
Predictors of nodule growth
- Age and initial nodule size were not predictors of nodule growth
Nodules ≥2 cm
- Patients with nodules 2 cm or larger
- 26 (38%)
Original publication
Nonoperative, Active Surveillance of Larger Malignant and Suspicious Thyroid Nodules. J Clin Endocrinol Metab. Published 13 February 2024. doi:10.
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