Patient-Reported Outcomes Three Years After Deciding on Surgery or Active Surveillance for Small, Low-Risk Papillary Thyroid Cancer: Results of a Prospective Cohort Study
Authors' conclusion
We observed that PROs do not significantly differ between patients who chose AS and those who chose immediate surgery a few years after the initial disease management choice. However, patients who crossover from AS to surgery may experience greater cancer-related worry and decision regret.
Study context
- Population
- Canadian patients with small (<2 cm), low-risk papillary thyroid cancer (PTC) given the choice of active surveillance (AS) or immediate surgeryresponse rate 64% (120/188)
- Participants
- 120 patients
- Exposure
- AS vs immediate surgery
- ASn = 98
- Immediate surgeryn = 22reference
- Outcome
- Patient-reported outcomes (PROs): overall and subscale scores of EORTC QLQ-C30, EORTC THY-34, Assessment of Survivor Concerns, Decision Regret Scale, GAD-7
- Follow-up
- Approximately three years after the initial disease management choice
Main finding
As reported in the abstract
PRO overall and subscale scores · median follow-up 42 months (IQR 39, 46)
- No significant differences in overall scores or subscales of any questionnaire between AS and immediate surgery
- After adjustment for multiple comparisons
Observational data: associations, not effects.
Further findings
Crossover from AS to surgery vs remained under AS and initial surgery
- Greater cancer-related worry with crossover
- P = 0.021
- Greater overall worry with crossover
- P = 0.021
- Greater decision regret with crossover
- P = 0.031
- Secondary analysis
Original publication
Patient-Reported Outcomes Three Years After Deciding on Surgery or Active Surveillance for Small, Low-Risk Papillary Thyroid Cancer: Results of a Prospective Cohort Study. Thyroid. Published 12 March 2026. doi:10.
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