Management of Sonographically Suspicious Thyroid Nodules 1 cm or Smaller and Candidacy for Active Surveillance: Experience of a Tertiary Center in China
| Autor: | Yi-Rui Zhou, Xiaohong Wu, Xiao Li, Xinhua Ye, Meiping Shen, Jianxiang Wang, Xingyue Cao, Rong Rong, Yong-Lian Hu |
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| Rok vydání: | 2020 |
| Předmět: |
Thyroid nodules
medicine.medical_specialty Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Lymph node metastasis Asymptomatic 03 medical and health sciences 0302 clinical medicine Endocrinology medicine Delayed surgery Humans 030212 general & internal medicine Thyroid Neoplasms Thyroid Nodule Watchful Waiting Lymph node Retrospective Studies medicine.diagnostic_test business.industry Nodule (medicine) General Medicine medicine.disease Bethesda system for reporting thyroid cytopathology Carcinoma Papillary Fine-needle aspiration medicine.anatomical_structure Thyroidectomy Radiology medicine.symptom Neoplasm Recurrence Local business |
| Zdroj: | Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 27(9) |
| ISSN: | 1530-891X |
| Popis: | Our objective was to investigate the management of patients with asymptomatic suspicious thyroid nodules ≤1 cm.We retrospectively reviewed medical records of patients with sonographically suspicious thyroid nodules ≤1 cm and without distant metastases, suspicious lymph node metastasis (LNM), or extrathyroidal extension (ETE).Of the 386 enrolled patients, 174 (45.1%) had immediate surgery (IS), while 212 (54.9%) underwent active surveillance (AS). In the IS group, 166 (95.4%) patients were confirmed as having papillary thyroid microcarcinoma. LNM and ETE were observed in 24.7% and 2.4% cases, respectively. In the AS group, nodule size increased by ≥3 mm in 11 (5.2%) patients and 39 (18.4%) had a50% increase in nodule volume after a median follow-up of 12 months. Nodules with smaller volume at diagnosis were more likely to increase in volume later. Newly suspicious LNM was detected in 23 (10.8%) patients. Delayed surgery (DS) was performed in 101 patients, with 27 showing disease progression. ETE and LNM were detected in 3% and 36%, respectively, of patients with papillary thyroid microcarcinoma. Compared with IS, tumors in the DS group more frequently showed lateral LNM and capsular invasion (P.05). No patient had recurrence or died of thyroid cancer during postoperative follow-up (median 26 [4-60] months).IS or DS of patients with asymptomatic suspicious thyroid nodules ≤1 cm was relatively high in China. The inertia of low-risk nodules and the effectiveness of DS for those that progressed make AS a feasible strategy. |
| Databáze: | OpenAIRE |
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