|Table of Contents|

The significance,challenges,and advancements in active surveillance strategies for low-risk thyroid cancer

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2025 06
Page:
889-892
Research Field:
Publishing date:

Info

Title:
The significance,challenges,and advancements in active surveillance strategies for low-risk thyroid cancer
Author(s):
GAO Ming; HAO Jie
Department of Breast and Thyroid Surgery,Tianjin Union Medical Center,the First Affiliated Hospital of Nankai University,Tianjin 300121,China.
Keywords:
low-risk thyroid cancer; active surveillance; stratified treatment; precise diagnosis
PACS:
R736.1
DOI:
10.3969/j.issn.1672-4992.2025.06.001
Abstract:
In recent years,the incidence of thyroid cancer has exhibited a notable upward trend,fueling discussions surrounding "overdiagnosis and overtreatment".For low-risk thyroid cancer,which accounts for a substantial proportion of cases,immediate surgical intervention is increasingly viewed as inconsistent with contemporary tumor stratification treatment guidelines.As a result,an active surveillance strategy has emerged as a promising alternative.However,the promotion of active surveillance for low-risk thyroid cancer in China encounters challenges such as limitations in precise diagnosis,inadequate standardization of operational procedures,and deficiencies in management systems.To facilitate its development in China,it is imperative to accelerate the implementation of advanced technology research and development to enhance diagnostic accuracy,promote the standardization of original clinical research on active surveillance,and strengthen policy guidance and improvements in management systems,and ultimately introduce new qualitative productivity into the discipline.

References:

［1］ LIM H,DEVESA SS,SOSA JA,et al.Trends in thyroid cancer incidence and mortality in the United States,1974-2013［J］.JAMA,2017,317(13):1338-1348.
［2］ ZANOCCO KA,HERSHMAN JM,LEUNG AM.Active surveillance of low-risk thyroid cancer［J］.JAMA,2019,321(20):2020-2021.
［3］ VACCARELLA S,FRANCESCHI S,BRAY F,et al.Worldwide thyroid-cancer epidemic? The increasing impact of overdiagnosis［J］.N Engl J Med,2016,375(7):614-617.
［4］ COOPER DS,DOHERTY GM,HAUGEN BR,et al.Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer:the American Thyroid Association (ATA) guidelines taskforce on thyroid nodules and differentiated thyroid cancer［J］.Thyroid,2009,19(11):1167-1214.
［5］ SCHLUMBERGER M,LEBOULLEUX S.Current practice in patients with differentiated thyroid cancer［J］.Nature Reviews Endocrinology,2021,17(3):176-188.
［6］ KIM JK,CHOI J,PARK KS,et al.Thyroid cancer-specific mortality during 2005-2018 in Korea,aftermath of the overdiagnosis issue:a nationwide population-based cohort study ［J］.International Journal of Surgery (London,England),2024,110(9):5489-5495.
［7］ MI YC,MINJU K,JIWOO L,et al.Long-term changes in the mortality rates of thyroid cancer in Korea:Analysis of Korean National Data from 1985 to 2020 ［J］.Endocrinology and Metabolism (Seoul,Korea),2023,38(5):588-595.
［8］ ITO Y,MIYAUCHI A,KIHARA M,et al.Patient age is significantly related to the progression of papillary microcarcinoma of the thyroid under observation ［J］.Thyroid,2014,24(1):27-34.
［9］ MARGHERITA P,MENGMENG L,JEROME V,et al.The epidemiological landscape of thyroid cancer worldwide:GLOBOCAN estimates for incidence and mortality rates in 2020 ［J］.The Lancet Diabetes & Endocrinology,2022,10(4):264-272.
［10］ ZHENG R,ZHANG S,ZENG H,et al.Cancer incidence and mortality in China,2016［J］.Journal of the National Cancer Center,2022,2(1):1-9.
［11］ HAN B,ZHENG R,ZENG H,et al.Cancer incidence and mortality in China,2022［J］.Journal of the National Cancer Center,2024,4(1):47-53.
［12］ 张华,李明,王强.中国三级医院甲状腺癌诊疗模式调查与分析［J］.中华内分泌外科杂志,2022,16(4):234-240. ZHANG H,LI M,WANG Q.Investigation and analysis of thyroid cancer diagnosis and treatment models in tertiary hospitals in China ［J］.Chinese Journal of Endocrine Surgery,2022,16(4):234-240.
［13］ TUTTLE RM,FAGIN JA,MINKOWITZ G,et al.Natural history and tumor volume kinetics of papillary thyroid cancers during active surveillance ［J］.JAMA Otolaryngol Head Neck Surg,2017,143(10):1015-1020.
［14］ LIU R,XING M.TERT promoter mutations in thyroid cancer［J］.Endocrine-Related Cancer,2016,23(3):R143-R155.
［15］ 高明,葛明华,嵇庆海,等.甲状腺微小乳头状癌诊断与治疗中国专家共识(2016版)［J］.中国肿瘤临床,2016,43(10):405-411. GAO M,GE MH,JI QH,et al.Chinese expert consensus on diagnosis and treatment of papillary thyroid microcarcinoma (2016 edition)［J］.Chinese Journal of Clinical Oncology,2016,43(10):405-411.
［16］ 中华医学会内分泌学分会,中华医学会外科学分会甲状腺及代谢外科学组,中国抗癌协会头颈肿瘤专业委员会,等.甲状腺结节和分化型甲状腺癌诊治指南(第二版)［J］.中华内分泌代谢杂志,2023,39(03):181-226. Chinese Society of Endocrinology,Chinese Medical Association;Thyroid and Metabolic Surgery Group,Chinese Society of Surgery,Chinese Medical Association;Chinese Anti-Cancer Association Head and Neck Tumor Committee,et al.Guidelines for the diagnosis and treatment of thyroid nodules and differentiated thyroid cancer (second edition)［J］.Chinese Journal of Endocrinology and Metabolism,2023,39(3):181-226.
［17］ 刘才广,莫屈,肖羿,等.医学影像人工智能在甲状腺癌诊疗中的应用:现状与展望［J］.中国普通外科杂志,2024,33(11):1874-1882. LIU CG,MO Q,XIAO Y,et al.Application of artificial intelligence in medical imaging for diagnosis and treatment of thyroid cancer:current status and prospects［J］.Chinese Journal of General Surgery,2024,33(11):1874-1882.
［18］ LI X,ZHANG S,ZHANG Q,et al.Diagnosis of thyroid cancer using deep convolutional neural network models applied to sonographic images:a retrospective,multicohort,diagnostic study［J］.The Lancet Oncology,2019,20(2):193-201.
［19］ 蔡建民,肖乐,李发荣,等.影像检查及人工智能在甲状腺乳头状癌被膜外侵犯诊断中的研究进展［J/OL］.现代肿瘤医学,1-7［2025-01-23］.http://kns.cnki.net/kcms/detail/ 61.1415.R.20241120.0854.008.html. CAI JM,XIAO L,LI FR,et al.Advances in imaging and artificial intelligence for diagnosing extrathyroidal extension of papillary thyroid carcinoma［J/OL］.Modern Oncology,2024:1-7 ［2025-01-23］.http://kns.cnki.net/kcms/detail/61.1415.R.20241120.0854.008.html.
［20］ WANG CW,MUZAKKY H,LEE YC,et al.Annotation-free deep learning-based prediction of thyroid molecular cancer biomarker BRAF (V600E) from cytological slides［J］.International Journal of Molecular Sciences,2023,24(3):2521.
［21］ ANAND D,YASHASHWI K,KUMAR N,et al.Weakly supervised learning on unannotated H&E-stained slides predicts BRAF mutation in thyroid cancer with high accuracy［J］.The Journal of Pathology,2021,255(3):232-242.

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