Evidence map›Paper›PMID 40425952›Full record

Observational studyEndocrine2025

A decade of active surveillance for low-risk papillary thyroid carcinoma in Argentina: persistent challenges in acceptance and discontinuation rates.

Anabella Smulever, Fabián Pitoia

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Endocrine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Anabella SmuleverDivision of Endocrinology, Instituto de Investigaciones Médicas A. Lanari, University of Buenos Aires, Buenos Aires, Argentina.ORCID 0000-0001-6497-315X
Fabián PitoiaDivision of Endocrinology, Hospital de Clínicas, University of Buenos Aires, Buenos Aires, Argentina. fpitoia@intramed.net.ORCID 0000-0002-2742-7085

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundActive surveillance (AS) for low-risk papillary thyroid carcinoma (PTC) has been practiced for over 30 years with encouraging results globally. However, its adoption remains limited in certain contexts. This study aimed to evaluate the long-term oncological outcomes of patients undergoing AS and compare changes in the acceptance and discontinuation rates in Argentina over the past decade.

methodsThis prospective, observational cohort study (2014-2024) included 358 patients diagnosed with low-risk PTC measuring ≤1.5 cm across two university hospitals. Of these, 104 patients (29%) opted for AS and were followed up with thyroid ultrasounds and function tests annually for at least 24 months. Surgery was recommended for tumors showing a ≥3 mm increase in size, newly detected foci, or metastatic involvement. Outcomes were analyzed in two distinct phases: 2014-2019 (A) and 2020-2024 (B).

resultsOf the 104 patients under AS, 10.6% developed tumor growth of ≥3 mm, and 7.6% developed new PTC foci. The 5- and 10-year cumulative incidence of tumor growth was 7 and 8%, respectively. Lymph node metastases occurred in 0.9%. AS acceptance rates remained stable between Phase A (25%) and Phase B (30%) (p = 0.82). AS discontinuation rates were also similar: 19.5% in A and 12.6% in B (p = 0.63). Among patients discontinuing AS due to tumor progression, 31% underwent surgery. Anxiety was the main reason for surgery in 66% of cases in Phase A and 40% in Phase B. Lobectomies increased from 1.5% (A) to 9% (B, p = 0.8). No evidence of disease was achieved in 84% of cases at the end of follow-up.

conclusionsDespite persistently low acceptance and adherence to AS, the long-term outcomes observed in this prospective study reinforce this approach as a feasible initial management option for low-risk PTC. These findings underscore the need for further efforts to improve the acceptance of AS among eligible patients.

Indexed as

Patient Acceptance of Health CareThyroid Cancer, PapillaryThyroid NeoplasmsWatchful WaitingAdultAgedArgentinaFemaleHumansMaleMiddle AgedProspective StudiesYoung AdultActive surveillanceDisease progressionImmediate surgeryLow-risk papillary thyroid carcinomaMicrocarcinomaPrognosis

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.