Study Protocol of Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro).
10.3803/EnM.2018.33.2.278
- Author:
Jae Hoon MOON
1
;
Ji hoon KIM
;
Eun Kyung LEE
;
Kyu Eun LEE
;
Sung Hye KONG
;
Yeo Koon KIM
;
Woo jin JUNG
;
Chang Yoon LEE
;
Roh Eul YOO
;
Yul HWANGBO
;
Young Shin SONG
;
Min Joo KIM
;
Sun Wook CHO
;
Su jin KIM
;
Eun Jae JUNG
;
June Young CHOI
;
Chang Hwan RYU
;
You Jin LEE
;
Jeong Hun HAH
;
Yuh Seog JUNG
;
Junsun RYU
;
Yunji HWANG
;
Sue K PARK
;
Ho Kyung SUNG
;
Ka Hee YI
;
Do Joon PARK
;
Young Joo PARK
Author Information
1. Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Thyroid neoplasms;
Active surveillance;
Prospective cohort;
Papillary thyroid microcarcinoma
- MeSH:
Biopsy, Fine-Needle;
Biopsy, Large-Core Needle;
Cohort Studies*;
Follow-Up Studies;
Humans;
Neoplasm Metastasis;
Prognosis;
Prospective Studies*;
Quality of Life;
Risk Factors;
Thyroid Gland*;
Thyroid Neoplasms;
Ultrasonography
- From:Endocrinology and Metabolism
2018;33(2):278-286
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The ongoing Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) aims to observe the natural course of papillary thyroid microcarcinoma (PTMC), develop a protocol for active surveillance (AS), and compare the long-term prognosis, quality of life, and medical costs between the AS and immediate surgery groups. METHODS: This multicenter prospective cohort study of PTMC started in June 2016. The inclusion criteria were suspicious of malignancy or malignancy based on fine needle aspiration or core needle biopsy, age of ≥18 years, and a maximum diameter of ≤1 cm. If there was no major organ involvement, no lymph node/distant metastasis, and no variants with poor prognosis, the patients were explained of the pros and cons of immediate surgery and AS before selecting AS or immediate surgery. Follow-up visits (physical examination, ultrasonography, thyroid function, and questionnaires) are scheduled every 6 months during the first 2 years, and then every 1 year thereafter. Progression was defined as a maximum diameter increase of ≥3, ≥2 mm in two dimensions, suspected organ involvement, or lymph node/distant metastasis. RESULTS: Among 439 enrolled patients, 290 patients (66.1%) chose AS and 149 patients (33.9%) chose immediate surgery. The median follow-up was 6.7 months (range, 0.2 to 11.9). The immediate surgery group had a larger maximum tumor diameter, compared to the AS group (7.1±1.9 mm vs. 6.6±2.0 mm, respectively; P=0.014). CONCLUSION: The results will be useful for developing an appropriate PTMC treatment policy based on its natural course and risk factors for progression.
