Active surveillance of papillary thyroid microcarcinomas in South America: Are we ready?

Debora Lucia Seguro Danilovic,João Roberto M Martins,Ana Luiza Maia

doi:10.20945/2359-3997000000180

Abstract

Active surveillance is defined as a strategy for treating a medical condition that involves a period of waiting and regular testing, rather than immediate treatment, such as surgery. In previous years, active surveillance (AS) of papillary thyroid microcarcinomas (mPTC; tumors with less than 1.0 cm) has been the focus of discussion worldwide, notably in the context of the epidemic of thyroid carcinomas diagnosed by neck imaging exams (). This practice was initially proposed in 1993 by Miyauchi and cols. and, [...]

Highlights

In this issue, two articles discuss the overdiagnosis of thyroid nodules and the active surveillance in mPTC as an alternative treatment in South American patients
In the other article, a group of Brazilian experts states a series of recommendations to avoid overdiagnosis of thyroid nodules and overtreatment of mPTC (6)
Clinical and imaging follow-up is recommended if the patient is not submitted to fine needle aspiration biopsy (FNAB)

Summary

Introduction

Two articles discuss the overdiagnosis of thyroid nodules and the active surveillance in mPTC as an alternative treatment in South American patients. Are we ready for active surveillance of mPTC? In the other article, a group of Brazilian experts states a series of recommendations to avoid overdiagnosis of thyroid nodules and overtreatment of mPTC (6). The authors suggested FNAB of very suspicious nodules ≤ 1 cm only if age < 40 years, presence of extrathyroidal extension on ultrasonography (US), nodule adjacent to the trachea or recurrent laryngeal nerve, multiple suspicious nodules, presence of suspicious lymph nodes or known distant metastases.

Results

Conclusion