Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands.
Academic Center for Thyroid Diseases, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
Head Neck. 2023 Jul;45(7):1772-1781. doi: 10.1002/hed.27389. Epub 2023 May 9.
Active surveillance is propagated as an alternative for hemithyroidectomy in the management of Bethesda III thyroid nodules.
A cross-sectional survey questioned respondents on their willingness to accept risks related to active surveillance and hemithyroidectomy.
In case of active surveillance, respondents (129 patients, 46 clinicians, and 66 healthy controls) were willing to accept a risk of 10%-15% for thyroid cancer and 15% for needing more extensive surgery in the future. Respondents were willing to accept a risk of 22.5%-30% for hypothyroidism after hemithyroidectomy. Patients and controls were willing to accept a higher risk on permanent voice changes compared with clinicians (10% vs. 3%, p < 0.001).
Real-life risks associated which active surveillance and hemithyroidectomy for Bethesda III nodules are equivalent or less than the risks people are willing to accept. Clinicians accepted less risk for permanent voice changes.
主动监测被宣传为治疗 Bethesda III 甲状腺结节的甲状腺叶切除术的替代方法。
一项横断面调查询问了受访者对主动监测和甲状腺叶切除术相关风险的接受意愿。
在主动监测的情况下，受访者（129 名患者、46 名临床医生和 66 名健康对照者）愿意接受 10%-15%的甲状腺癌风险和 15%的未来需要更广泛手术的风险。受访者愿意接受甲状腺叶切除术后 22.5%-30%的甲状腺功能减退症风险。与临床医生相比，患者和对照组更愿意接受永久性嗓音改变的高风险（10%比 3%，p<0.001）。
与 Bethesda III 结节的主动监测和甲状腺叶切除术相关的实际风险与人们愿意接受的风险相当或更低。临床医生对永久性嗓音改变的风险接受程度较低。
