Low-risk papillary thyroid carcinoma

clinical outcomes of active surveillance management

Abstract

Introduction: A epidemic increase in the incidence of papillary thyroid carcinoma (PTC) has been happening within the last 25 years. The majority of those tumors are low-risk, and some studies reported low progression rates of low-risk PTC. It suggests that immediate surgery may not be the best option, specially when considering the intrinsic risk to a thyroidectomy and inconvenience of lifelong hormone replacement. In this systematic review we compare the outcomes of active surveillance for the primary management of low-risk PTC. Methods: The review was conducted based on three studies selected from specific databases. These studies followed up low-risk patients nonoperatively and surgery was performed if needed. Results: All studies reported low percentages of tumor growth and metastatic disease during active surveillance. Furthermore, no significant differences between immediate surgery and late rescue surgery were reported, and active surveillance appears to be cheaper than the tradicional conduct. Conclusions: Active surveillance seems to be a good alternative for low-risk PTC management, yet, more long-term and bigger research is still needed, specially outside of a japanese population.