Yuyang Ze1, Xiaowen Zhang2, Fei Shao2, Lin Zhu2, Shanmei Shen3, Dalong Zhu4, Yan Bi5. 1. Department of Endocrinology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China. 2. Department of Endocrinology, The Affiliated Hospital of Nanjing University Medical School, Nanjing Drum Tower Hospital, 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China. 3. Department of Endocrinology, The Affiliated Hospital of Nanjing University Medical School, Nanjing Drum Tower Hospital, 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China. shanmeishen@126.com. 4. Department of Endocrinology, The Affiliated Hospital of Nanjing University Medical School, Nanjing Drum Tower Hospital, 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China. zhudalong@nju.edu.cn. 5. Department of Endocrinology, The Affiliated Hospital of Nanjing University Medical School, Nanjing Drum Tower Hospital, 321 Zhongshan Road, Nanjing, 210008, Jiangsu Province, China. biyan@nju.edu.cn.
Abstract
PURPOSE: Papillary thyroid carcinoma (PTC), the most common malignant tumor of the thyroid, has been criticized as overtreated by some researchers in recent years. Active surveillance (AS) was first proposed at Kuma Hospital in 1993, and popularized in other institutes ever since. We provide a brief review of low-risk PTC active monitoring studies to date, and discuss the advantages of AS and limitations of existing studies. RESULTS: Most papillary thyroid microcarcinomas do not show significant growth or new lymph node metastasis in a 10-year AS period. Patients who undergo delayed surgery during AS generally have a good prognosis. Tumor progression correlates with age, calcification pattern, and Ki-67 positivity. Serum thyroid stimulating hormone concentration and pregnancy might also influence tumor progression in some studies. CONCLUSION: Active surveillance for low-risk PTC has shown its safety and feasibility in certain populations. In the future, it is warranted to determine valuable tumor progression predictors and most suitable PTC patients for AS.
PURPOSE:Papillary thyroid carcinoma (PTC), the most common malignant tumor of the thyroid, has been criticized as overtreated by some researchers in recent years. Active surveillance (AS) was first proposed at Kuma Hospital in 1993, and popularized in other institutes ever since. We provide a brief review of low-risk PTC active monitoring studies to date, and discuss the advantages of AS and limitations of existing studies. RESULTS: Most papillary thyroid microcarcinomas do not show significant growth or new lymph node metastasis in a 10-year AS period. Patients who undergo delayed surgery during AS generally have a good prognosis. Tumor progression correlates with age, calcification pattern, and Ki-67 positivity. Serum thyroid stimulating hormone concentration and pregnancy might also influence tumor progression in some studies. CONCLUSION: Active surveillance for low-risk PTC has shown its safety and feasibility in certain populations. In the future, it is warranted to determine valuable tumor progression predictors and most suitable PTCpatients for AS.
Entities:
Keywords:
Active surveillance; Low-risk; Observation; Papillary carcinoma; Thyroid
Authors: Minjing Zou; Essa Y Baitei; Ali S Alzahrani; Faisal S BinHumaid; Dania Alkhafaji; Roua A Al-Rijjal; Brian F Meyer; Yufei Shi Journal: Thyroid Date: 2014-06-10 Impact factor: 6.568
Authors: Yoram Cohen; Mingzhao Xing; Elizabeth Mambo; Zhongmin Guo; Guogun Wu; Barry Trink; Uziel Beller; William H Westra; Paul W Ladenson; David Sidransky Journal: J Natl Cancer Inst Date: 2003-04-16 Impact factor: 13.506