Tumor Growth Kinetics Based on Initial Tumor Volume Doubling Time in Active Surveillance of Low-Risk Papillary Thyroid Carcinoma
Authors' conclusion
An i-TVDT of <5 years serves as an important prognostic indicator for disease progression, including tumor growth and new LN metastasis.
Study context
- Population
- Patients with low-risk PTC sized <2 cm under active surveillance, follow-up over 3 years
- Participants
- 402 patients
- Outcome
- Clinical outcomes and tumor growth kinetics during active surveillance
- Follow-up
- Median 5 years
Main finding
As reported in the abstract
median follow-up 5 years
- New cervical lymph node (LN) metastasis
- 3.4% (14/402)
- Maximal diameter increase ≥3 mm
- 8.2% (33/402)
- Initial TV doubling time (i-TVDT) <5 years independent risk factor for maximal diameter growth
- p < 0.001
- i-TVDT <5 years independent risk factor for new LN metastasis
- p = 0.04
- Four tumor kinetic patterns (p < 0.001): Stable
- 67.7%
- Rapid growth (tumor volume (TV) increase >75% and i-TVDT <5 years); median onset of growth 2.0 years
- 17.2%
- Slow growth (TV increase >75% and i-TVDT ≥5 years); grew at median 4.3 years
- 10.9%
- Shrinkage (TV decrease >75%)
- 4.2%
Observational data: associations, not effects.
Further findings
Papillary thyroid microcarcinoma
- Diagnosed with papillary thyroid microcarcinoma
- 93.3% (375/402)
Delayed surgery >12 months after initiating active surveillance (AS)
- Underwent delayed surgery
- 115 (28.6%)
- Reason: patient preference
- 51/115, 44.3%
- Reason: disease progression
- 31/115, 27.0%
- Reason: suspected disease progression (growth not meeting ≥3 mm increase)
- 17/115, 14.8%
Original publication
Tumor Growth Kinetics Based on Initial Tumor Volume Doubling Time in Active Surveillance of Low-Risk Papillary Thyroid Carcinoma. Thyroid. Published 12 July 2024. doi:10.
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