High rate incidence of post-surgical adverse events in patients with low-risk papillary thyroid cancer who did not accep
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ORIGINAL ARTICLE
High rate incidence of post-surgical adverse events in patients with low-risk papillary thyroid cancer who did not accept active surveillance Anabella Smulever
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Fabián Pitoia
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Received: 26 January 2020 / Accepted: 6 April 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To describe the outcomes and the incidence of adverse events following active surveillance (AS) versus immediate surgery in patients with low-risk papillary thyroid carcinoma (PTC). Methods We prospectively evaluated 286 patients who attended the Hospital de Clínicas, with a single thyroid nodule 30 ng/ml or increasing Tg values over time with similar TSH levels or rising TgAb levels and negative imaging. Indeterminate response was defined as nonspecific findings on imaging studies or TgAb levels stable or declining in the absence of structural disease [21]. Our hospital’s Ethical Committee approved the present study. All the participants provided written informed consent for data collection.
Statistical analysis Continuous data were presented as means (SDs) or medians (ranges) and interquartile range, as appropriate for each variable. Statistical analyses to determine any significant differences between the AS and immediate-surgery groups were compared using Chi2 for categorical variables and a t test for comparison of two means for continuous variables with normal distribution. The percentage of change in tumor size of patients under AS was calculated relative to the baseline estimated in ultrasound at diagnosis. A meaningful change in tumor size was defined as an increase greater than 3 mm from baseline before the initial fine-needle aspiration. The statistical tests used to compare the differences adverse events between AS and immediate-surgery groups were the Mann–Whitney U test for skewed variables and the Wilcoxon signed-rank test for paired skewed variables. All statistical analyses were conducted using SPSS, 24.0 version (IBM Corp). P values 3 mm) (n = 6)
P value
41.5 (15–79.7)
42.1 (32.3–79.7)
ns
Age at diagnosis, y Median (range)
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