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KMID : 1141520180330020278
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Endocrinology and Metabolism
2018 Volume.33 No. 2 p.278 ~ p.286
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Study Protocol of Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro)
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Moon Jae-Hoon
Kim Ji-Hoon
Lee Eun-Kyung
Lee Kyu-Eun
Kong Sung-Hye
Kim Yeo-Koon
Jung Woo-Jin
Lee Chang-Yoon
Yoo Roh-Eul
Hwangbo Yul
Song Young-Shin
Kim Min-Joo
Cho Sun-Wook
Kim Su-Jin
Jung Eun-Jae
Choi June-Young
Ryu Chang-Hwan
Lee You-Jin
Hah Jeong-Hun
Jung Yuh-Seog
Ryu Jun-Sun
Hwang Yun-Ji
Park Sue-K.
Sung Ho-Kyung
Yi Ka-Hee
Park Do-Joon
Park Young-Joo
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Abstract
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Background: The ongoing Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) aims to observe the natural course of papillary thyroid microcarcinoma (PTMC), develop a protocol for active surveillance (AS), and compare the long-term prognosis, quality of life, and medical costs between the AS and immediate surgery groups.
Methods: This multicenter prospective cohort study of PTMC started in June 2016. The inclusion criteria were suspicious of malignancy or malignancy based on fine needle aspiration or core needle biopsy, age of ≥18 years, and a maximum diameter of ≤1 cm. If there was no major organ involvement, no lymph node/distant metastasis, and no variants with poor prognosis, the patients were explained of the pros and cons of immediate surgery and AS before selecting AS or immediate surgery. Follow-up visits (physical examination, ultrasonography, thyroid function, and questionnaires) are scheduled every 6 months during the first 2 years, and then every 1 year thereafter. Progression was defined as a maximum diameter increase of ≥3, ≥2 mm in two dimensions, suspected organ involvement, or lymph node/distant metastasis.
Results: Among 439 enrolled patients, 290 patients (66.1%) chose AS and 149 patients (33.9%) chose immediate surgery. The median follow-up was 6.7 months (range, 0.2 to 11.9). The immediate surgery group had a larger maximum tumor diameter, compared to the AS group (7.1±1.9 mm vs. 6.6±2.0 mm, respectively; P=0.014).
Conclusion: The results will be useful for developing an appropriate PTMC treatment policy based on its natural course and risk factors for progression.
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KEYWORD
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Thyroid neoplasms, Active surveillance, Prospective cohort, Papillary thyroid microcarcinoma
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