Current treatment strategies for papillary thyroid microcarcinoma

Abstract

Surgical treatment of papillary thyroid microcarcinoma (PTMC) is evolving more and more into acontroversial issue. As in Japan more than 50% of PTMCs are only observed, an increasing number of physicians in the western world are calling for active surveillance instead of lobectomy or total thyroidectomy. Unifocal carcinomas of older patients without extrathyroidal growth or lymph node involvement seem to be candidates for active surveillance. First estimations for a lifelong observation show that patients <30years old will have aprobability of tumor progression of more than 60%. Adecision for surgery versus active surveillance has to weigh up all the arguments for and against, which have to be discussed and planned in detail together with the patient.