{"id":343651,"date":"2015-03-06T01:00:00","date_gmt":"2015-03-06T00:00:00","guid":{"rendered":"https:\/\/medizinonline.com\/is-active-monitoring-enough\/"},"modified":"2015-03-06T01:00:00","modified_gmt":"2015-03-06T00:00:00","slug":"is-active-monitoring-enough","status":"publish","type":"post","link":"https:\/\/medizinonline.com\/en\/is-active-monitoring-enough\/","title":{"rendered":"Is active monitoring enough?"},"content":{"rendered":"<p><strong>There are some centers that advocate pursuing a strategy of active surveillance without surgery for small papillary thyroid carcinomas (PTC), which are increasingly encountered in clinical practice. A population-based cohort study has now examined how many and which patients die from small PTC in the first place. This can be used to define at-risk patients for whom active observation could be dangerous.<\/strong><\/p>\n<p> <!--more--> <\/p>\n<p>Specifically, the study [1] aimed to determine the disease-specific mortality of PTCs with a maximum extension of \u22642 cm.<\/p>\n<p>A US registry from 1988-2007 (61 523 patients) served as the data basis. The characteristics of deceased patients with such tumor size and the influence of clinical procedures on patient survival were examined.<\/p>\n<h2 id=\"which-characteristics-play-a-role\">Which characteristics play a role?<\/h2>\n<ul>\n<li>Throughout the 20-year study period, the thyroid cancer-associated mortality rate was 2.8% (1753 patients). What about the small PTCs?<\/li>\n<li>Of those who died, 38% had PTC, 10% had follicular, and 31.3% had anaplastic thyroid carcinoma.<\/li>\n<li>Of those who died, 12.3% had a PTC of the size described above (\u22642 cm). They all died even though they had undergone thyroidectomy. These cases were significantly more likely to be men (30 vs. 17%), \u226545 years old (92 vs. 52%), have tumor size greater than one centimeter (59 vs. 46%), extrathyroidal spread (41 vs. 11%), lymph node (77 vs. 28%), and distant metastases (31 vs. 1%) compared with individuals with small PTC who were still alive. This can be used to characterize a risk population that is very unlikely to be suitable for a nonoperative approach.<\/li>\n<li>Of these characteristics, age (\u226545 years), metastases, extrathyroidal spread, and just remarkably, procedures that were less than lobectomy of the thyroid gland in extent were independent risk factors for death.<\/li>\n<\/ul>\n<h2 id=\"caution-is-advised\">Caution is advised<\/h2>\n<p>Because of the relatively high death rate even of operated PTC patients, the authors conclude that nonoperative management of small PTCs should be used cautiously-especially in men who have exceeded an age of 45 years. These require at least one lobectomy of the thyroid gland.<\/p>\n<p>&nbsp;Literature:<\/p>\n<ol>\n<li>Nilubol N, et al: Should small papillary thyroid cancer be observed? A population-based study. Cancer 2014. doi: 10.1002\/cncr.29123.<\/li>\n<\/ol>\n<p>\n<em>InFo ONCOLOGY &amp; HEMATOLOGY 2015; 3(2): 2<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>There are some centers that advocate pursuing a strategy of active surveillance without surgery for small papillary thyroid carcinomas (PTC), which are increasingly encountered in clinical practice. A population-based cohort&hellip;<\/p>\n","protected":false},"author":7,"featured_media":49776,"comment_status":"closed","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"pmpro_default_level":"","cat_1_feature_home_top":false,"cat_2_editor_pick":false,"csco_eyebrow_text":"Small papillary thyroid carcinomas","footnotes":""},"category":[11500,11370,11548,11503],"tags":[47759,20570,11555],"powerkit_post_featured":[],"class_list":["post-343651","post","type-post","status-publish","format-standard","has-post-thumbnail","category-news-en","category-oncology","category-rx-en","category-studies","tag-ptc-en","tag-thyroid-cancer-en","tag-thyroid-gland","pmpro-has-access"],"acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-06-30 09:00:07","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"wpml_current_locale":"en_US","wpml_translations":{"fr_FR":{"locale":"fr_FR","id":343660,"slug":"la-surveillance-active-est-elle-suffisante","post_title":"La surveillance active est-elle suffisante ?","href":"https:\/\/medizinonline.com\/fr\/la-surveillance-active-est-elle-suffisante\/"},"it_IT":{"locale":"it_IT","id":343665,"slug":"il-monitoraggio-attivo-e-sufficiente","post_title":"Il monitoraggio attivo \u00e8 sufficiente?","href":"https:\/\/medizinonline.com\/it\/il-monitoraggio-attivo-e-sufficiente\/"},"pt_PT":{"locale":"pt_PT","id":343669,"slug":"a-monitorizacao-activa-e-suficiente","post_title":"A monitoriza\u00e7\u00e3o activa \u00e9 suficiente?","href":"https:\/\/medizinonline.com\/pt-pt\/a-monitorizacao-activa-e-suficiente\/"},"es_ES":{"locale":"es_ES","id":343672,"slug":"es-suficiente-una-vigilancia-activa","post_title":"\u00bfEs suficiente una vigilancia activa?","href":"https:\/\/medizinonline.com\/es\/es-suficiente-una-vigilancia-activa\/"}},"_links":{"self":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/posts\/343651","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/comments?post=343651"}],"version-history":[{"count":0,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/posts\/343651\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/media\/49776"}],"wp:attachment":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/media?parent=343651"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/category?post=343651"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/tags?post=343651"},{"taxonomy":"powerkit_post_featured","embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/powerkit_post_featured?post=343651"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}