Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Endocrinol Metab (Seoul). 2021 Aug;36(4):717-724. doi: 10.3803/EnM.2021.1042. Epub 2021 Aug 11.
Active surveillance (AS) for low-risk papillary thyroid microcarcinoma (PTMC) has been accepted worldwide as safe and effective. Despite the growing acceptance of AS in the management of low-risk PTMCs, there are barriers to AS in real clinical settings, and it is important to understand and establish appropriate AS protocol from initial evaluation to follow-up. PTMC management strategies should be decided upon after careful consideration of patient and tumor characteristics by a multidisciplinary team of thyroid cancer specialists. Patients should understand the risks and benefits of AS, participate in decision-making and follow structured monitoring strategies. In this review, we discuss clinical outcomes of AS from previous studies, optimal indications and follow-up strategies for AS, and unresolved questions about AS.
主动监测(AS)在低危甲状腺微小乳头状癌(PTMC)的应用已在全球范围内被接受,且安全有效。尽管 AS 在低危 PTMC 的管理中越来越被接受,但在实际临床环境中仍存在障碍,因此,了解并建立从初始评估到随访的合适的 AS 方案非常重要。PTMC 的管理策略应由甲状腺癌专家组成的多学科团队根据患者和肿瘤的特征仔细考虑后决定。患者应了解 AS 的风险和获益,参与决策并遵循结构化的监测策略。在这篇综述中,我们讨论了之前研究中 AS 的临床结果、AS 的最佳适应证和随访策略,以及 AS 相关的未解决问题。