R. Michael Tuttle, MD
Results from an analysis of 3D tumor volume measurements shows papillary thyroid cancers (PTC) ≤1.5 cm grew slowly during a period of active surveillance, suggesting that surgery may not be necessary for all patients.1
“In addition to supporting active surveillance in a population outside of Japan, the study has provided a very important template for patient selection,” Scharpf wrote. “It is interesting that nearly 80% of their study population were patients with a tumor size of 1.0 cm or less. Under the most current American Thyroid Association guidelines, there is a recommendation (recommendation 8) against fine-needle aspiration biopsy of thyroid nodules less than 1.0 cm. Therefore, this approach makes sense for this group of patients who perhaps should not have been diagnosed with thyroid cancer at this size level. It is anticipated that incidental detection of small PTCs will continue to increase, and it is imperative to continually explore new approaches to avoid potential overtreatment while still identifying tumors that would continue to grow.”
- Tuttle RM, Fagin JA, Minkowitz G, et al. Natural history and tumor volume kinetics of papillary thyroid cancers during active surveillance [published online August 31, 2017]. JAMA Otolaryngol Head Neck Surg. doi:10.1001/jamaoto.2017.1442.
- Scharpf J. Achieving active surveillance for thyroid cancer—not a euphemism for watching a ticking time bomb [published online August 31, 2017]. JAMA Otolaryngol Head Neck Surg. doi:10.1001/jamaoto.2017.1453.
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