Patient Experience of Thyroid Cancer Active Surveillance in Japan

Davies, Louise; Roman, Benjamin R.; Fukushima, Mitsuhiro; Ito, Yasuhiro; Miyauchi, Akira

doi:10.1001/jamaoto.2018.4131

Cited by 96 publications

(82 citation statements)

References 48 publications

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“…21,29 In addition to the optimization of inclusion and exclusion criteria, the anxiety or resistance of patients (or even physicians) during active surveillance is another valid consideration that is still being studied. 21,53,54 However, a complete explanation is very important in relieving patient fears. For this reason, it is important to provide information and education on this subject to physicians who interact with these patients.…”

Section: Optimal Management Of Papillary Thyroid Microcarcinomamentioning

confidence: 99%

Low‐risk papillary thyroid microcarcinoma: Optimal management toward a more conservative approach

Ramundo

Sponziello

Falcone

et al. 2020

Journal of Surgical Oncology

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The incidence of papillary thyroid microcarcinoma (microPTC) has dramatically increased in the last decades. Most of these tumors remain small and clinically “silent”, only small number progress. Although thyroid surgery used to be the only therapeutic approach, recent guidelines now consider active surveillance for low‐risk microPTC. For this reason, more accurate risk stratification of microPTC is needed. The optimal management of low‐risk microPTC through accurate risk stratification represents a major clinical issue.

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Section: Optimal Management Of Papillary Thyroid Microcarcinomamentioning

confidence: 99%

Low‐risk papillary thyroid microcarcinoma: Optimal management toward a more conservative approach

Ramundo

Sponziello

Falcone

et al. 2020

Journal of Surgical Oncology

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“…This also raises an interesting question as to whether the PTC found in neck nodes may have arisen from benign lateral aberrant thyroid tissue or is indeed metastatic disease from a true microscopic carcinoma, which is clinically and/or radiologically inapparent. With increasing evidence in the literature on the success of active surveillance programs for biopsy‐proven papillary microcarcinomas, it would be logical to consider these patients with true microscopic carcinomas in thyroid gland to be candidates for active surveillance . Thus, active surveillance of the thyroid and neck after adequate diagnostic work up (eg, thyroid ultrasound, CT scan, and/or PET‐CT) may be an effective strategy in appropriately selected patients.…”

Section: Discussionmentioning

confidence: 99%

“…With increasing evidence in the literature on the success of active surveillance programs for biopsy-proven papillary microcarcinomas, it would be logical to consider these patients with true microscopic carcinomas in thyroid gland to be candidates for active surveillance. 20,21 Thus, active surveillance of the thyroid and neck after adequate diagnostic work up (eg, thyroid ultrasound, CT scan, and/or PET-CT) may be an effective strategy in appropriately selected patients.…”

Section: Discussionmentioning

confidence: 99%

Significance and management of incidentally diagnosed metastatic papillary thyroid carcinoma in cervical lymph nodes in neck dissection specimens

et al. 2019

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Background The management of patients with incidentally discovered metastatic thyroid cancer in cervical lymph nodes in neck dissection specimens for other pathologies is unclear. Methods Retrospective review of neck dissection specimens for nonthyroid malignancy during a 30‐year period was undertaken to identify incidental metastatic papillary thyroid cancer (PTC). Results Twenty‐six patients had an incidental finding of PTC in lymph node(s) in neck dissection specimens. Subsequent ultrasound of the thyroid showed nodules in 20 patients. Eleven (42%) underwent total thyroidectomy, 1 (4%) had a lobectomy, and 14 (54%) were kept under active surveillance only. At a median follow‐up of 48 months (range 10‐189 months), all patients who had undergone surgery and those under surveillance were free of PTC recurrence. Conclusion Evaluation for detection of a primary thyroid tumor is essential in all patients with incidentally discovered metastatic PTC. Decision regarding surgery or surveillance is dependent on clinical and radiological tumor features and patient factors.

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“…Through a combination of patient surveys and interviews, they revealed that patients overall worry about cancer recurrence, metastases, and need for surgical intervention to a similar degree as patients who undergo surgery. 45 The proportion of patients who did not worry about their cancer outcomes steadily increased over the course of the surveillance period, and a large percentage of patients (83%) agreed that AS was the best management option for them. Additionally, and importantly, a large proportion of patients (77%) were not aware of AS as a treatment modality before it was offered to them.…”

Section: Contribution Of the Thyroid Surgeon To Shared Decision-makingmentioning

confidence: 99%

“…A study performed by Davies et al sought specifically to assess the experience of patients undergoing AS. Through a combination of patient surveys and interviews, they revealed that patients overall worry about cancer recurrence, metastases, and need for surgical intervention to a similar degree as patients who undergo surgery . The proportion of patients who did not worry about their cancer outcomes steadily increased over the course of the surveillance period, and a large percentage of patients (83%) agreed that AS was the best management option for them.…”

Section: Introductionmentioning

confidence: 99%

Active surveillance for patients with very low‐risk thyroid cancer

Lohia

Hanson

Tuttle

et al. 2020

Laryngoscope Investig Oto

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Over the past 30 years in the United States, increasing identification of small thyroid nodules has led to a dramatic rise in the detection of small thyroid cancers, many of which are unlikely to progress to overt clinical disease. Because autopsy studies reveal that up to 30% of people harbor clinically occult thyroid cancers, the growing use of diagnostic technologies has identified an increasing number of small, clinically low risk papillary thyroid cancers (PTCs). In recent years, clinical practice has evolved to de‐intensify the treatment for PTCs, with fewer total thyroidectomy and nodal dissection procedures being performed, in favor of more limited operations. In addition, vigilant observation of selected low risk cancers has demonstrated outcomes comparable to those patients who undergo immediate surgical intervention. Active surveillance has emerged as a new option within the treatment algorithm of PTCs. There is now robust data from cancer centers in Japan and Korea which have reported excellent oncologic outcomes among patients undergoing active surveillance for PTC, as well as more recent, similar data from the United States. American Thyroid Association guidelines now include the option of active surveillance for appropriately selected patients with low‐risk PTC. With active surveillance now one option within the standard of care for patients with certain thyroid cancers, surgeons have become critical to facilitating shared decision‐making for patients facing this diagnosis.

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Patient Experience of Thyroid Cancer Active Surveillance in Japan

Cited by 96 publications

References 48 publications

Low‐risk papillary thyroid microcarcinoma: Optimal management toward a more conservative approach

Low‐risk papillary thyroid microcarcinoma: Optimal management toward a more conservative approach

Significance and management of incidentally diagnosed metastatic papillary thyroid carcinoma in cervical lymph nodes in neck dissection specimens

Active surveillance for patients with very low‐risk thyroid cancer

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