Who Is Eligible for Thyroid Cancer Active Surveillance in a Population with a Restrictive Diagnostic Protocol?

2021 ◽  
Vol 33 (3) ◽  
pp. 124-127
Author(s):  
Camilo Gonzalez-Velazquez ◽  
Juan P. Brito
Keyword(s):  
Thyroid Cancer ◽  
Active Surveillance ◽  
Diagnostic Protocol

scholarly journals Decision-making in Surgery or Active Surveillance for Low Risk Papillary Thyroid Cancer During the COVID-19 Pandemic

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 371
Author(s):  
Anna Sawka ◽  
Sangeet Ghai ◽  
Ogemdi Ihekire ◽  
Jennifer Jones ◽  
Amiram Gafni ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Papillary Thyroid Cancer ◽  
Active Surveillance ◽  
Low Risk ◽  
Observational Research ◽  
Papillary Thyroid ◽  
Missed Appointments ◽  
Physician Visits ◽  
Observational Cohort ◽  
Study Participants

We describe our experience conducting a prospective observational cohort study on the management of small, low risk papillary thyroid cancer during the COVID-19 pandemic. Our study participants are given the choice of active surveillance (AS) or surgery, and those in the AS arm are followed at the study center, whereas surgical patients undergo usual care. During the pandemic we have transitioned from in-person research patient visits to largely virtual care of patients under AS. As of 30 October 2020, we had enrolled 181 patients enrolled in our study (including 25 during the pandemic), of which 92.3% (167/181) consented to telephone communication and 79.0% (143/181) consented to secure videoconferencing communication. Prior to the pandemic, 74.5% (117/157) of our patients chose AS over surgery, whereas during the pandemic, 96.0% (24/25) chose AS. Of the 133 study patients who were under AS within the timeframe from 12 March 2020, to 30 October 2020, the percentage of patients who missed appointments was 8.3% (11/133, for neck ultrasound and physician visits, respectively) and delayed appointments was 23.3% (31/133). This preliminary data suggests that prospective observational research on AS of thyroid cancer can safely continue during the pandemic.

scholarly journals Suspicious Cervical Lymph Nodes Detected after Thyroidectomy for Papillary Thyroid Cancer Usually Remain Stable Over Years in Properly Selected Patients

2012 ◽  
Vol 97 (8) ◽  
pp. 2706-2713 ◽  
Author(s):  
E. Robenshtok ◽  
S. Fish ◽  
A. Bach ◽  
Jose M. Domínguez ◽  
A. Shaha ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Active Surveillance ◽  
Regional Recurrence ◽  
Lateral Neck ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes ◽  
Value Range ◽  
Almost All

Abstract Context: The risk of loco-regional recurrence in papillary thyroid cancer (PTC) patients ranges from 15–30%. However, the clinical significance of small-volume loco-regional recurrence detected by highly sensitive ultrasonography is unclear. Objective: Our objective was to describe the natural history of abnormal cervical lymph nodes (LN) diagnosed after initial treatment. Design: We conducted a retrospective cohort study. Patients: 166 PTC with patients who had at least one abnormal LN outside the thyroid be on ultrasound and selected for active surveillance were included. Main Outcome Measure: LN growth during a period of active surveillance was the primary outcome. Results: Most patients had classical PTC (85%) and an intermediate risk of recurrence (77%). The median LN size at the start of the observation period was 1.3 cm (range, 0.5–2.7 cm) in largest diameter, with all nodes having at least one abnormal sonographic characteristic (70% of patients had LN with at least two abnormal features). In almost all patients, the LN were in the lateral neck, primarily in levels 3 (43%) and 4 (58%). After a median follow-up of 3.5 yr, only 20% (33 of 166) grew at least 3 mm, 9% (15 of 166) grew at least 5 mm, and 14% (23 of 166) resolved. None of the clinical or sonographic features were predictive of LN growth (positive predictive value range = 0.21–0.57). There were no local complications (nerve damage or local invasion) related to the abnormal nodes and no disease-related mortality. Conclusions: Suspicious cervical LN in the lateral neck usually remain stable for long periods of time in properly selected PTC patients and can be safely followed with serial ultrasounds

scholarly journals COVID-19 pandemic and Thyroid cancer treatment in perspective of Bangladesh

2021 ◽  
Vol 29 (2) ◽  
pp. 178-181
Author(s):  
Mahmud Asif Rifat ◽  
Mostafa Kamal Arefin ◽  
Abu Yusuf Fakir ◽  
SK Nurul Fattah Rumi ◽  
Husne Qumer Osmany ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Active Surveillance ◽  
Hospital Admissions ◽  
Lung Metastases ◽  
Vulnerable Groups ◽  
Severe Illness ◽  
Medical College ◽  
Increased Risk

Background: The COVID-19 pandemic in Bangladesh is part of the worldwide pandemic of coronavirus disease 2019 which has crowded out services for both covid and non-covid patients, in a country where the health care system was already under huge stress even before the pandemic. Objectives: To postpone non-urgent surgeries along with active surveillance of thyroid cancer patients to make sure the hospitals are not unnecessarily occupied. Methods: Document based categorization of thyroid cancer patients, like- low risk, high risk and clinically extremely vulnerable groups who are at greatest risk of severe illness from coronavirus are to be done accordingly. Individuals with thyroid cancer are mostly not susceptible to COVID- 19. However, patients with thyroid cancer (papillary or medullary) having lung metastases or undergoing certain types of cancer treatment might be at increased risk of viral infection or complications. Risk benefit ratio is checked and explained to the patient and their attendants. Recommendations: As COVID-19 is spreading across the Bangladesh, hospitals are being forced to reallocate resources to the care of critically ill. So it is crucial to adhere to the advice from experts to reduce the risk of infection. All non-essential surgeries and hospital admissions can be postponed to make sure that hospitals are not unnecessarily occupied. Conclusion: In the face of the COVID-19 pandemic, cancer care has had to adapt rapidly given recommendations to postpone nonurgent surgeries with active surveillance of thyroid cancer patients except thyroid tumors requiring acute airway management. J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 178-181

Sign in / Sign up

Export Citation Format

Share Document