Active Surveillance for Locoregional Recurrent Differentiated Thyroid Cancer: A Systematic Review and Meta-Analysis - PubMed
4 days ago
- #thyroid cancer
- #active surveillance
- #meta-analysis
- Active surveillance (AS) is a proposed management option for recurrent thyroid cancer but has limited evidence due to retrospective studies and small sample sizes.
- A systematic review and meta-analysis of 10 retrospective studies (n=841) was conducted to estimate disease progression during AS for recurrent thyroid cancers.
- The pooled mean follow-up duration was 51.6 months, with an overall pooled progression rate of 23%, higher in biopsy-confirmed cases (32%).
- Progression rates were higher in studies with <40 months mean follow-up (36%) compared to ≥40 months (17%).
- Higher baseline serum thyroglobulin levels and advanced tumor stage (Stage IV) were associated with increased progression rates.
- Adjustment for follow-up loss increased estimated progression rates to 35-70%, suggesting current rates may be underestimated.
- AS should be considered cautiously, especially in patients with elevated thyroglobulin levels or advanced tumor stage, who may need closer monitoring.