Active Surveillance for Low-Risk Thyroid Cancers: A Review of Current Practice Guidelines
- Author:
Min Joo KIM
1
;
Jae Hoon MOON
;
Eun Kyung LEE
;
Young Shin SONG
;
Kyong Yeun JUNG
;
Ji Ye LEE
;
Ji-hoon KIM
;
Kyungsik KIM
;
Sue K. PARK
;
Young Joo PARK
Author Information
- Publication Type:Review Article
- From:Endocrinology and Metabolism 2024;39(1):47-60
- CountryRepublic of Korea
- Language:EN
- Abstract: The indolent nature and favorable outcomes associated with papillary thyroid microcarcinoma have prompted numerous prospective studies on active surveillance (AS) and its adoption as an alternative to immediate surgery in managing low-risk thyroid cancer. This article reviews the current status of AS, as outlined in various international practice guidelines. AS is typically recommended for tumors that measure 1 cm or less in diameter and do not exhibit aggressive subtypes on cytology, extrathyroidal extension, lymph node metastasis, or distant metastasis. To determine the most appropriate candidates for AS, factors such as tumor size, location, multiplicity, and ultrasound findings are considered, along with patient characteristics like medical condition, age, and family history. Moreover, shared decision-making, which includes patient-reported outcomes such as quality of life and cost-effectiveness, is essential. During AS, patients undergo regular ultrasound examinations to monitor for signs of disease progression, including tumor growth, extrathyroidal extension, or lymph node metastasis. In conclusion, while AS is a feasible and reliable approach for managing lowrisk thyroid cancer, it requires careful patient selection, effective communication for shared decision-making, standardized follow-up protocols, and a clear definition of disease progression.
