Pushing the Envelope for Active Surveillance
Mené aux Etats-Unis entre 2014 et 2021 sur 222 patients atteints d'un cancer de la thyroïde à faible risque (durée moyenne de suivi : 37,1 mois ; âge médian : 46,8 ans ; 76% de femmes), cet essai non randomisé évalue l'efficacité, du point de vue de la croissance volumétrique du nodule et du niveau d'anxiété du patient, de la surveillance active par rapport à une chirurgie immédiate
Thyroid cancer is the most common cancer among young adults and the seventh most common among women. Papillary thyroid cancer (PTC), a category of differentiated thyroid cancer, accounts for up to 90% of thyroid cancer. Diagnosis of thyroid cancer has steadily increased over time, partly because of overdiagnosis of subcentimeter microcarcinomas. The 2015 American Thyroid Association guidelines recommended active surveillance as an alternative for very low-risk tumors based on early evidence from observational and cohort studies in Japan and Korea that demonstrated low rates of disease progression. Despite these recommendations, the US has been slow to adopt active surveillance.
JAMA Oncology , éditorial, 2021