Abstract
In this chapter, active surveillance as the initial management for low-risk papillary microcarcinoma (PMC) of the thyroid is described. As imaging modalities (including ultrasound) have improved, small thyroid nodules, including PMCs, are more frequently detected. The question of whether immediate surgery for all asymptomatic and low-risk PMCs without lymph node or distant metastasis is beneficial for patients has remained. At Kuma Hospital in Kobe, Japan, active surveillance as the initial course of action for PMC was initiated in 1993. In our study, only 8% of 1235 PMCs enlarged to ≥3 mm, and 3.8% of the PMCs showed the novel appearance of lymph node metastasis. None of the patients showed distant metastasis or died of thyroid carcinoma during the active surveillance. No significant recurrence was observed after surgery among the 191 PMC patients who showed size enlargement or the appearance of lymph node metastasis during active surveillance. These findings suggest that the active surveillance of low-risk PMCs can be the initial course of action for this disease.
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Ito, Y., Miyauchi, A., Oda, H. (2017). Active Surveillance as the Initial Course of Action in Low-Risk Papillary Microcarcinoma. In: Mancino, A., Kim, L. (eds) Management of Differentiated Thyroid Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-54493-9_11
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DOI: https://doi.org/10.1007/978-3-319-54493-9_11
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