1934P - Active surveillance for higher-risk papillary thyroid carcinoma in China: A 10-year retrospective study

Background

Active surveillance (AS) is gradually becoming a new strategy for low-risk papillary thyroid carcinoma (PTC). The prognosis statistics and data of AS for relatively higher-risk PTC patients in China are limited. The purpose is to explore the feasibility and safety of AS in higher-risk PTC in China.

Methods

This retrospective study included PTC patients from October 2013 to October 2023. All cases were confirmed by biopsy and attended Ruijin Hospital, a tertiary referral hospital in China. Based on comprehensive risk levels, nodules that exhibit specific risk factors (larger nodule size, multifocality, located in the isthmus, and adjacent to the thyroid capsule) present a relatively higher overall risk, in comparison to the low-risk group, are defined as relatively higher-risk group.

Results

A total of 245 patients (278 nodules) were included in this study, comprising 193 (78.78%) females and 52 (21.22%) males. The number of low-risk PTC and higher-risk PTC groups were 164 and 81, respectively. The median age of the cohort was 39 (34-45) years. There was no statistically significant difference in diameter increase (0% vs. 2.47%, P=0.11), volume increase (18.91% vs. 20.99%, P=0.83), and the lymph node metastasis (LNM) rate (1.83% vs. 4.94%, P=0.49) between the low-risk PTC and relatively higher-risk PTC groups. No significant differences in the cumulative incidence of disease progression between the two groups (Kaplan-Meier analysis, all p>0.05). For patients chosen for surgery after AS, there was no significant statistically difference observed in the lymph node metastasis rates (1.83% vs. 4.94%, p=0.49). No local progression disease, distant metastasis and death due to PTC case were observed. 84.24% of patients diagnosed with PTC experienced mild to moderate levels of anxiety during the AS. In 61.84% of cases, doctors act as facilitators behind AS.

Conclusions

No significant statistically difference in disease progression was observed between the low-risk PTC and higher-risk PTC groups. Our preliminary results indicate that AS may be a novel option for relatively higher-risk PTC populations.

Clinical trial identification

Editorial acknowledgement

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.