ArticleExpert review of endocrinology & metabolism2018
A clinical framework to facilitate selection of patients with differentiated thyroid cancer for active surveillance or less aggressive initial surgical management.
Article in Expert review of endocrinology & metabolism, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.
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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.
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Who cites it
37 citing papers in PubMed.
- Therapeutic Strategy in Low-Risk Papillary Thyroid Carcinoma - Long-Term Results of the First Single-Center Prospective Non-Randomized Trial Between 2011 and 2015.Frontiers in endocrinology · 2021Trial
- Ablative Therapies in Low-Risk Thyroid Cancer.Annals of surgical oncology · 2025Review
- Observational
- Multicenter study of thermal ablation versus partial thyroidectomy for paratracheal papillary thyroid microcarcinoma.European radiology · 2025Article
- Is conservative treatment always safe in unifocal clinically T1a/node-negative papillary thyroid carcinoma?World journal of surgery · 2025Article
- A nomogram for predicting adverse pathologic features in low-risk papillary thyroid microcarcinoma.BMC cancer · 2024Article
- Differentiated thyroid cancer: a focus on post-operative thyroid hormone replacement and thyrotropin suppression therapy.Endocrine · 2024Review
- Thirty years of active surveillance for low-risk thyroid cancer, lessons learned and future directions.Reviews in endocrine & metabolic disorders · 2024Review
- Dynamic risk assessment in patients with differentiated thyroid cancer.Reviews in endocrine & metabolic disorders · 2024Review
- Active surveillance for micropapillary thyroid carcinoma: a clinical review.Gland surgery · 2024Review
- Implementing active surveillance for low-risk thyroid carcinoma into clinical practice: collaborative recommendations for Latin America.Archives of endocrinology and metabolism · 2024Review
- The Incidence Trend and Management of Thyroid Cancer-What Has Changed in the Past Years: Own Experience and Literature Review.Cancers · 2023Article
- Is There a Role for Levothyroxine Therapy in Euthyroid Patients on Active Surveillance for Papillary Microcarcinoma?Thyroid : official journal of the American Thyroid Association · 2023Article
- Clinical value of artificial intelligence in thyroid ultrasound: a prospective study from the real world.European radiology · 2023Article
- Large (>4 cm) Intrathyroidal Encapsulated Well-Differentiated Follicular Cell-Derived Carcinoma Without Vascular Invasion May Have Negligible Risk of Recurrence Even When Treated with Lobectomy Alone.Thyroid : official journal of the American Thyroid Association · 2023Article
- Conservative management of low-risk papillary thyroid carcinoma: a review of the active surveillance experience.Thyroid research · 2023Review
- Invasion of a Recurrent Laryngeal Nerve from Small Well-Differentiated Papillary Thyroid Cancers: Patient Selection Implications for Active Surveillance.Thyroid : official journal of the American Thyroid Association · 2022Article
- Development of an Active Surveillance or Surgery Model to Predict Lymph Node Metastasis in cN0 Papillary Thyroid Microcarcinoma.Frontiers in endocrinology · 2022Article
- Ultrasound-Guided Percutaneous Laser Ablation of the Thyroid Gland in a Swine Model: Comparison of Ablation Parameters and Ablation Zone Dimensions.Cardiovascular and interventional radiology · 2021Article
- Prognostic factors for incomplete response in thyroid microcarcinoma: an analysis of initial response to therapy in 517 patients.Archives of endocrinology and metabolism · 2021Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
introductionIn the past, total thyroidectomy was usually recommended as the initial therapeutic approach in all but the lowest risk differentiated thyroid cancers. Today, many patients with low risk papillary thyroid cancers may be candidates for either an observational management approach (active surveillance/deferred surgical intervention) or a minimalist surgical approach (thyroid lobectomy/isthmusectomy). AREAS COVERED: After a comprehensive review of the PubMed database and based on our clinical experience, we describe a clinical framework that integrates important factors in three major inter-related domains (pre-operative imaging/clinical findings, medical team characteristics, and patient characteristics) to classify a patient as either ideal, appropriate or inappropriate for conservative treatment options. As part of this clinical framework, we examine how the medical decision making construct (minimalist versus maximalist) of the patient and clinician can impact selection of initial therapy. EXPERT COMMENTARY: The dramatic rise in the incidence of very low risk differentiated thyroid cancer demands a re-evaluation of the appropriate use of more minimalistic treatment options. The selection of appropriate patients for less aggressive initial treatment options requires thoughtful, open discussions that can be aided by clinical decision making frameworks that recognize and value the medical decision making process of clinicians and patients.
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