Assessing mPTC Progression during Active Surveillance: Volume or Diameter Increase?
Active surveillance (AS) is considered an alternative to immediate surgery in micropapillary thyroid carcinoma (mPTC). However, the definition of clinical mPTC progression during AS is controversial. We evaluated changes in tumor size using both tumor diameters and volume in 109 patients with mPTC f...
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doaj-ecf25df7d7894f8eafc9d43e067ac7d82021-09-26T00:27:55ZengMDPI AGJournal of Clinical Medicine2077-03832021-09-01104068406810.3390/jcm10184068Assessing mPTC Progression during Active Surveillance: Volume or Diameter Increase?Maria Cristina Campopiano0Antonio Matrone1Teresa Rago2Maria Scutari3Alessandro Prete4Laura Agate5Paolo Piaggi6Rossella Elisei7Eleonora Molinaro8Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, 56124 Pisa, ItalyUnit of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, 56124 Pisa, ItalyUnit of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, 56124 Pisa, ItalyUnit of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, 56124 Pisa, ItalyUnit of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, 56124 Pisa, ItalyUnit of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, 56124 Pisa, ItalyUnit of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, 56124 Pisa, ItalyUnit of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, 56124 Pisa, ItalyUnit of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, 56124 Pisa, ItalyActive surveillance (AS) is considered an alternative to immediate surgery in micropapillary thyroid carcinoma (mPTC). However, the definition of clinical mPTC progression during AS is controversial. We evaluated changes in tumor size using both tumor diameters and volume in 109 patients with mPTC followed in an AS protocol for a mean period of 31 ± 18 months. At the time of data lock, 19/109 (17.4%) mPTC reached and maintained a volume increase of ≥50%. However, only 3/19 (15.7%) showed progression, according to the diameter increase. The remaining 16 showed a slight diameter growth without reaching the original protocol progression criteria. The mean mPTC growth rate in stable cases was 0.37 mm<sup>3</sup>/month, while it was significantly greater in the mPTC, which achieved a volume change ≥50% with respect to the other. The two mPTC that developed a significant diameter increase had a growth rate of 41 and 18 mm<sup>3</sup>/month. Instead, the growth rates of the three mPTC that developed lymph node metastases were 0, 2.5 and 16 mm<sup>3</sup>/month. The ≥50% volume increase appears to be a too sensitive marker of disease progression, with a downstream higher surgery rate. The assessment of growth rate could distinguish mPTC with high and low growth rates, which would allow us to tailor the algorithm of the evaluations to a more appropriate timing.https://www.mdpi.com/2077-0383/10/18/4068differentiated thyroid cancerpapillary thyroid microcarcinomaactive surveillancemanagementobservationtailored treatment for thyroid cancer |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Maria Cristina Campopiano Antonio Matrone Teresa Rago Maria Scutari Alessandro Prete Laura Agate Paolo Piaggi Rossella Elisei Eleonora Molinaro |
spellingShingle |
Maria Cristina Campopiano Antonio Matrone Teresa Rago Maria Scutari Alessandro Prete Laura Agate Paolo Piaggi Rossella Elisei Eleonora Molinaro Assessing mPTC Progression during Active Surveillance: Volume or Diameter Increase? Journal of Clinical Medicine differentiated thyroid cancer papillary thyroid microcarcinoma active surveillance management observation tailored treatment for thyroid cancer |
author_facet |
Maria Cristina Campopiano Antonio Matrone Teresa Rago Maria Scutari Alessandro Prete Laura Agate Paolo Piaggi Rossella Elisei Eleonora Molinaro |
author_sort |
Maria Cristina Campopiano |
title |
Assessing mPTC Progression during Active Surveillance: Volume or Diameter Increase? |
title_short |
Assessing mPTC Progression during Active Surveillance: Volume or Diameter Increase? |
title_full |
Assessing mPTC Progression during Active Surveillance: Volume or Diameter Increase? |
title_fullStr |
Assessing mPTC Progression during Active Surveillance: Volume or Diameter Increase? |
title_full_unstemmed |
Assessing mPTC Progression during Active Surveillance: Volume or Diameter Increase? |
title_sort |
assessing mptc progression during active surveillance: volume or diameter increase? |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-09-01 |
description |
Active surveillance (AS) is considered an alternative to immediate surgery in micropapillary thyroid carcinoma (mPTC). However, the definition of clinical mPTC progression during AS is controversial. We evaluated changes in tumor size using both tumor diameters and volume in 109 patients with mPTC followed in an AS protocol for a mean period of 31 ± 18 months. At the time of data lock, 19/109 (17.4%) mPTC reached and maintained a volume increase of ≥50%. However, only 3/19 (15.7%) showed progression, according to the diameter increase. The remaining 16 showed a slight diameter growth without reaching the original protocol progression criteria. The mean mPTC growth rate in stable cases was 0.37 mm<sup>3</sup>/month, while it was significantly greater in the mPTC, which achieved a volume change ≥50% with respect to the other. The two mPTC that developed a significant diameter increase had a growth rate of 41 and 18 mm<sup>3</sup>/month. Instead, the growth rates of the three mPTC that developed lymph node metastases were 0, 2.5 and 16 mm<sup>3</sup>/month. The ≥50% volume increase appears to be a too sensitive marker of disease progression, with a downstream higher surgery rate. The assessment of growth rate could distinguish mPTC with high and low growth rates, which would allow us to tailor the algorithm of the evaluations to a more appropriate timing. |
topic |
differentiated thyroid cancer papillary thyroid microcarcinoma active surveillance management observation tailored treatment for thyroid cancer |
url |
https://www.mdpi.com/2077-0383/10/18/4068 |
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