Abstract
Low-risk papillary thyroid carcinomas (LR-PTC, tumors ≤1.5 cm) cause virtually no deaths, and are rapidly increasing in incidence due to overdiagnosis of subclinical disease. Herein we review the evidence base and the rationale behind a strategy of active surveillance of LR-PTC. We review natural history studies by Ito et al. and Tuttle et al., which to date form the backbone of literate on the subject. These studies provide good evidence supporting the hypothesis that LR-PTC is not a deadly disease even when observed. There is little additional evidence on patient reported outcomes (PROs, e.g. quality of life) and cost issues as they relate to an active surveillance strategy. We compare this body of literature to evidence regarding surgery for LR-PTC.
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