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Following more than 1,200 patients with small papillary thyroid cancers under observation, the Kuma Hospital group found that only 8 percent grew and under 4 percent developed node metastases over ten years, with the lowest risk in older patients, establishing surveillance as a safe alternative to surgery.
Prospective observational cohort of 1,235 patients with low-risk papillary thyroid microcarcinoma managed by active surveillance between 1993 and 2011, analysing tumour enlargement and nodal metastasis by age.
Ten-year rates of tumour enlargement of 3 mm or more and of new node metastases were 8.0 and 3.8 percent; progression was most frequent in patients under 40 and rarest in those over 60, and no patient died of thyroid cancer or developed distant metastases.
Active surveillance is a guideline-endorsed option for papillary microcarcinoma, adopted in Japan, the United States and elsewhere, especially for older patients.
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