The Natural Course of Low-Risk Papillary Thyroid Microcarcinoma During Pregnancy: A Prospective Active Surveillance Study
Authors' conclusion
While pregnancy may transiently accelerate tumor growth in low-risk PTMC, most gestational changes are self-limited, with stabilization or regression commonly observed postpartum.
Study context
- Population
- Female patients with low-risk papillary thyroid microcarcinoma (PTMC) under active surveillance (AS) with complete serial US documentation, single institution, February 2020 to October 202421 pregnancy events
- Participants
- 18 patients
- Exposure
- Tumor growth before pregnancy, during pregnancy and after delivery
- Outcome
- Changes in tumor size and growth velocity (tumor doubling rate, TDR) before pregnancy, during pregnancy and after delivery
Methodological detailssingle-institution, active surveillance cohort, time-stratified comparisons, Prospective AS cohort enrolled 260 female patients with low-risk PTMC
- Single-institution
- Active surveillance cohort
- Time-stratified comparisons
- Prospective AS cohort enrolled 260 female patients with low-risk PTMC
Main finding
As reported in the abstract
TDR
During pregnancy
0.39
/year
After delivery
−0.01
/year
P = 0.006
- Accelerated (tumor doubling rate (TDR) >0.5/year) or moderate growth (TDR 0.1-0.5/year) during pregnancy
- 76.2% (16/21)
- Postpartum stabilization (TDR −0.1 to 0.1/year) or regression (TDR <−0.1/year)
- 71.4% (15/21)
Observational data: associations, not effects.
Further findings
Tumor enlargement (>3 mm) by last follow-up · median follow-up 59.0 (IQR 38.5, 72.0) months
- PTMC cases with tumor enlargement (>3 mm)
- 19.0% (4/21)
Safety
Surgical and oncologic safety of AS
- Delayed surgery required
- 2 patients
- No instances of expanded surgical scope, T-stage progression or tumor recurrence observed
Original publication
The Natural Course of Low-Risk Papillary Thyroid Microcarcinoma During Pregnancy: A Prospective Active Surveillance Study. Thyroid. Published 22 May 2025. doi:10.
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