Thyroid Cancer 101: When is watching the small thyroid cancer better than immediate surgery?
When do I consider Active Surveillance AS with deferred surgery for my <1.5 micro-papillary cancer if needed over immediate thyroid surgery?
GRiffin et al Thyroid Jan. 27 2017, studied 243 cases of thyroid cancer to see how many would have been a candidate for active surveillance instead of immediate surgery.Also how many surgeries and complications avoided with AS.Using<1- 1.5 cm as the criteria 56/243 were included. 3/56 had permanent complications. Vocal paralysis,hypoparathyroidism, and a chipped tooth from intubation. No deaths or recurrent disease. Using 1.5 size criteria one quarter of patients would be candidate to defer surgery under Active Surveillance. Without Active Surveillance the majority of low risk cancers would have thyroid surgery and carry a small risk of permanent complications.
A third course for those who do not want the cancer in their neck for years and do not want surgery either there are 2 ablation procedures that can destroy the cancer inside the thyroid. ( ethanol PEI and radiofrequency RFA ).
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Richard Guttler MD,FACE,ECNU