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ArticleEndocrinology and metabolism (Seoul, Korea)2025

Study Protocol of Expanded Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro-EXP).

Jae Hoon Moon, Eun Kyung Lee, Wonjae Cha, Young Jun Chai, Sun Wook Cho, June Young Choi, Sung Yong Choi, A Jung Chu, Eun-Jae Chung, Yul Hwangbo and 27 more

Abstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Endocrinology and metabolism (Seoul, Korea), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
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  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

37 authors.

Jae Hoon MoonDepartment of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Eun Kyung LeeDepartment of Internal Medicine, National Cancer Center, Goyang, Korea.
Wonjae ChaDepartment of Otorhinolaryngology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Young Jun ChaiDepartment of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
Sun Wook ChoDepartment of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
June Young ChoiDepartment of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Sung Yong ChoiCenter for Thyroid Cancer, National Cancer Center, Goyang, Korea.
A Jung ChuDepartment of Radiology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
Eun-Jae ChungDepartment of Otorhinolaryngology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Yul HwangboDepartment of Internal Medicine, National Cancer Center, Goyang, Korea.
Woo-Jin JeongDepartment of Otorhinolaryngology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Yuh-Seog JungCenter for Thyroid Cancer, National Cancer Center, Goyang, Korea.
Kyungsik KimDepartment of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
Min Joo KimDepartment of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Su-Jin KimDepartment of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Woochul KimDepartment of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Yoo Hyung KimDepartment of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Chang Yoon LeeCenter for Thyroid Cancer, National Cancer Center, Goyang, Korea.
Ji Ye LeeDepartment of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Kyu Eun LeeDepartment of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Young Ki LeeDepartment of Internal Medicine, National Cancer Center, Goyang, Korea.
Hunjong LimDepartment of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Do Joon ParkDepartment of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Sue K ParkDepartment of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
Chang Hwan RyuCenter for Thyroid Cancer, National Cancer Center, Goyang, Korea.
Junsun RyuCenter for Thyroid Cancer, National Cancer Center, Goyang, Korea.
Jungirl SeokDepartment of Otorhinolaryngology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Young Shin SongDepartment of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
Ka Hee YiDepartment of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
Hyeong Won YuDepartment of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Eleanor WhiteFaculty of Medicine and Health, University of Sydney, Camperdown, Sydney, Australia.
Katerina MastrocostasDepartment of Radiology, Royal North Shore Hospital, Sydney, Australia.
Roderick J Clifton-BlighFaculty of Medicine and Health, University of Sydney, Camperdown, Sydney, Australia.
Anthony GloverFaculty of Medicine and Health, University of Sydney, Camperdown, Sydney, Australia.
Matti L GildFaculty of Medicine and Health, University of Sydney, Camperdown, Sydney, Australia.
Ji-Hoon KimDepartment of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Young Joo ParkDepartment of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Funding

Ministry of Health and Welfare RS-2023-KH142322
6 · The paper itself

Abstract

backgroundActive surveillance (AS) has emerged as a viable management strategy for low-risk papillary thyroid microcarcinoma (PTMC), following pioneering trials at Kuma Hospital and the Cancer Institute Hospital in Japan. Numerous prospective cohort studies have since validated AS as a management option for low-risk PTMC, leading to its inclusion in thyroid cancer guidelines across various countries. From 2016 to 2020, the Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) enrolled 1,177 patients, providing comprehensive data on PTMC progression, sonographic predictors of progression, quality of life, surgical outcomes, and cost-effectiveness when comparing AS to immediate surgery. The second phase of MAeSTro (MAeSTro-EXP) expands AS to low-risk papillary thyroid carcinoma (PTC) tumors larger than 1 cm, driven by the hypothesis that overall risk assessment outweighs absolute tumor size in surgical decision-making.

methodsThis protocol aims to address whether limiting AS to tumors smaller than 1 cm may result in unnecessary surgeries for low-risk PTCs detected during their rapid initial growth phase. By expanding the AS criteria to include tumors up to 1.5 cm, while simultaneously refining and standardizing the criteria for risk assessment and disease progression, we aim to minimize overtreatment and maintain rigorous monitoring to improve patient outcomes.

conclusionThis study will contribute to optimizing AS guidelines and enhance our understanding of the natural course and appropriate management of low-risk PTCs. Additionally, MAeSTro-EXP involves a multinational collaboration between South Korea and Australia. This cross-country study aims to identify cultural and racial differences in the management of low-risk PTC, thereby enriching the global understanding of AS practices and their applicability across diverse populations.

Indexed as

Carcinoma, PapillaryThyroid NeoplasmsWatchful WaitingDisease ProgressionFemaleFollow-Up StudiesHumansMaleMulticenter Studies as TopicPrognosisProspective StudiesQuality of LifeThyroidectomyImmediate surgeryStudy protocolThyroid cancer, papillaryWatchful waiting

Identifiers

PMID39962344
PMCPMC12061745

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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.