ArticleWorld journal of surgery2016
Clinical Trials of Active Surveillance of Papillary Microcarcinoma of the Thyroid.
Article in World journal of surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 100 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
100 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Risk factors for tumor enlargement in low-risk papillary thyroid microcarcinoma patients: a systematic review and meta-analysis.Endocrine · 2024Pooled it
- Papillary Thyroid Microcarcinoma: Active Surveillance Against Surgery. Considerations of an Italian Working Group From a Systematic Review.Frontiers in oncology · 2022Pooled it
- Association of Patient Age With Progression of Low-risk Papillary Thyroid Carcinoma Under Active Surveillance: A Systematic Review and Meta-analysis.JAMA otolaryngology-- head & neck surgery · 2020Pooled it
- Five Advances in the Last 50 Years That Have Impacted Endocrine Surgery.World journal of surgery · 2026Review
- Ultrasound-based nomogram for predicting central lymph node metastasis in papillary thyroid microcarcinoma.BMC endocrine disorders · 2026Article
- Global research landscape on active surveillance for papillary thyroid microcarcinoma: a bibliometric analysis.Discover oncology · 2025Article
- Active Surveillance of Papillary Thyroid Cancer-A Feasibility Experience from a Tertiary Care Centre.Indian journal of surgical oncology · 2025Article
- Low Ki-67 labeling index is a clinically useful predictive factor for recurrence-free survival in patients with papillary thyroid carcinoma.Journal of pathology and translational medicine · 2025Article
- Papillary thyroid microcarcinoma and papillary thyroid carcinoma: Clinical characteristics and stratification of treatment strategies.PloS one · 2025Article
- Papillary thyroid carcinoma measuring 1.0 cm or less: an epidemiological and clinicopathological study.Frontiers in oncology · 2025Article
- Propensity analysis reveals survival disparities between T1a and T1b well-differentiated thyroid cancer based on surgery.Gland surgery · 2024Article
- Active Surveillance in Early Thyroid Cancer: A Meta-Analysis.Diagnostics (Basel, Switzerland) · 2024Article
- Central Neck Dissection in Papillary Thyroid Carcinoma: Benefits and Doubts in the Era of Thyroid Lobectomy.Biomedicines · 2024Article
- Impact of a simple informative leaflet on Brazilian doctors' attitudes towards active surveillance of thyroid microcarcinomas.Heliyon · 2024Article
- Predictive Values of Clinical Features and Multimodal Ultrasound for Central Lymph Node Metastases in Papillary Thyroid Carcinoma.Diagnostics (Basel, Switzerland) · 2024Review
- Survey of clinician perspective on management of papillary thyroid microcarcinoma in Australia and New Zealand.Gland surgery · 2024Article
- The effect of COVID-19 pandemic restrictions on the management of differentiated thyroid cancer in Turkey: a single tertiary centre experience.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2024Article
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- Active surveillance for micropapillary thyroid carcinoma: a clinical review.Gland surgery · 2024Review
40 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe incidence of thyroid cancer is increasing globally. This is mainly due to the increase in the detection of small papillary carcinomas, including papillary microcarcinomas (PMC) 1 cm or smaller. It was suggested recently that PMCs are overdiagnosed and overtreated.
methodsIn 1993, the author proposed a clinical trial to compare surgery and observation for low-risk PMC at doctors' meeting in Kuma Hospital, which was approved and the trial started in the same year. Patients choose immediate surgery or observation. This paper shares our 22-year experience with the active surveillance of more than 2000 patients with low-risk PMC and compares the outcomes of immediate surgery with that of active observation.
resultsThe oncological outcomes of these management groups were similarly excellent. In our active surveillance trial on 1235 patients, 8% of patients showed tumor enlargement by 3 mm or more at 10 years of observation, and 3.8% of the patients showed novel appearance of lymph node metastasis at 10 years. Patients 40 years or younger tended to show progression of the disease. Patients with these slight progressions of the disease were successfully treated with a rescue surgery. None of the patients in both study groups died of the disease. However, incidences of unfavorable events, such as temporary vocal cord paralysis (VCP) and temporary and permanent hypoparathyroidism, were significantly higher in the immediate surgery group than in the observation group (4.1 vs. 0.6%, p < 0.0001; 16.7 vs. 2.8%, p < 0.0001; and 1.6 vs. 0.08%, p < 0.0001, respectively). Permanent VCP occurred in two of the surgery group.
conclusionsAs a result, although we still offer two options, immediate surgery or observation, to patients with low-risk PMC at Kuma Hospital, we now strongly recommend observation as the best choice.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.