Abstract
Introduction
Active surveillance (AS) is considered an alternative to immediate surgery (IS) for
low-risk papillary thyroid microcarcinoma (PTMC) patients. However, it is difficult
to decide between AS and IS due to limited evidence regarding risks and benefits for
patients in China.
Methods
This study prospectively enrolled 485 patients with highly suspicious thyroid nodules
</= 1 cm who chose AS and 331 patients who underwent IS during the same period. The
oncological outcomes, adverse events and quality of life, were compared between the
two groups.
Results
The oncological outcomes of the IS and AS groups were similarly excellent. The IS
group had significantly higher rates of temporary vocal cord paralysis (VCP) and temporary
hypoparathyroidism than the AS group (2.7% vs. 0.2%, p = 0.002; 13.6% vs.1.9%, p < 0.001,
respectively). The IS group had significantly more patients on hormone replacement
therapy (98.4% vs. 10.9%, p < 0.001) and a significantly higher incidence of neck
scarring (94.3% vs. 9.1%, p < 0.001) compared to the AS group. In the early stages,
the quality of life questionnaire showed significant differences with respect to three
items: voice, throat/mouth, and surgical scarring, with more complaints in the IS
group. However, one year or more after surgery, the main complaint was surgical scarring.
Conclusion
In China, AS can achieve similar short-term therapeutic effects as IS. As this approach
can reduce the occurrence of unfavorable events, achieve better quality of life, it
is a feasible option for patients with highly suspicious thyroid nodules.
Keywords
Abbreviations:
LNMs (Lymph node metastases), BT (Blood test), THYCA-QoL (Thyroid cancer-specific health-related quality of life)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 25, 2023
Accepted:
April 24,
2023
Received in revised form:
April 22,
2023
Received:
February 21,
2023
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
