Outcomes and effectiveness of active surveillance for low-risk papillary thyroid carcinoma: a systematic review and meta-analysis.

IF 1.9 3区 医学 Q2 OTORHINOLARYNGOLOGY European Archives of Oto-Rhino-Laryngology Pub Date : 2024-12-12 DOI:10.1007/s00405-024-09141-7
Van Cuong Nguyen, Chang Myeon Song, Yong Bae Ji, Shinje Moon, Jung Hwan Park, Dong Sun Kim, Kyung Tae
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Abstract

Purpose: This study aimed to evaluate the outcomes and effectiveness of active surveillance (AS) in patients with low-risk papillary thyroid carcinoma (PTC) and compare them to those of immediate surgery (IS).

Methods: A systematic review and meta-analysis, including 14 comparative studies and 7 noncomparative studies, was conducted, encompassing a total of 9,397 patients.

Results: AS was associated with lower rates of familial history of thyroid cancer, multiplicity, and overall mortality compared to IS. The disease progression rate during AS was 14.53% (95% CI, 9.59-21.43%), and the delayed surgery rate was 14.91% (95% CI, 8.35-25.21%). No thyroid cancer-related mortality was observed in either the AS and IS groups. Clinicopathological characteristics showed no significant differences between delayed surgery and IS, except for higher rates of extrathyroidal extension and multiplicity in the delayed surgery group. Overall complication and recurrence rates were higher in the delayed surgery group than in the IS group. Quality of life and anxiety levels were similar between AS and IS, except for interest in sex, where AS was more beneficial.

Conclusion: AS is a feasible and reliable option for managing low-risk PTC, with a relatively low rate of disease progression and no thyroid cancer-related mortality. However, AS should be undertaken with caution, given the higher rates of overall complications and recurrence in the delayed surgery group compared to the IS group. Further studies with larger sample sizes and long-term follow-up are needed to clarify the role and effectiveness of AS.

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低风险甲状腺乳头状癌主动监测的结果和有效性:系统综述和荟萃分析。
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来源期刊
CiteScore
5.30
自引率
7.70%
发文量
537
审稿时长
2-4 weeks
期刊介绍: Official Journal of European Union of Medical Specialists – ORL Section and Board Official Journal of Confederation of European Oto-Rhino-Laryngology Head and Neck Surgery "European Archives of Oto-Rhino-Laryngology" publishes original clinical reports and clinically relevant experimental studies, as well as short communications presenting new results of special interest. With peer review by a respected international editorial board and prompt English-language publication, the journal provides rapid dissemination of information by authors from around the world. This particular feature makes it the journal of choice for readers who want to be informed about the continuing state of the art concerning basic sciences and the diagnosis and management of diseases of the head and neck on an international level. European Archives of Oto-Rhino-Laryngology was founded in 1864 as "Archiv für Ohrenheilkunde" by A. von Tröltsch, A. Politzer and H. Schwartze.
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