{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:54:37Z","timestamp":1790697277919,"version":"4.1.0"},"reference-count":15,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:sec id=\"ab-ooi240040-4\"><jats:title>Importance<\/jats:title><jats:p>The outcomes of patients with low-risk thyroid cancer who undergo surgery following a period of active surveillance (AS) are not well-defined.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240040-5\"><jats:title>Objective<\/jats:title><jats:p>To evaluate surgical, pathologic, and oncologic outcomes among patients undergoing conversion surgery (CS) following AS for low-risk papillary thyroid carcinoma.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240040-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>In this cohort study, patients who underwent CS for disease progression were compared with patients who underwent CS without disease progression and with a propensity score\u2013matched cohort of patients who underwent initial surgery (IS). The median (IQR) postsurgical follow-up time was 40.3 (18.0-59.0) months. Patients were treated at a quaternary cancer referral center in the United States.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240040-7\"><jats:title>Exposures<\/jats:title><jats:p>Surgery.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240040-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Surgical complications, pathologic characteristics, overall survival (OS), and recurrence-free survival (RFS).<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240040-9\"><jats:title>Results<\/jats:title><jats:p>Of 550 patients who underwent AS, 55 (10.0%) had CS, of whom 39 (7.1%) had surgery due to suspected disease progression (median [IQR] age, 48 [39-56] years; 32 [82.1%] female). There were no clinically meaningful differences in rates of surgical sequalae between the progression CS group (12 of 39 [30.7%]) and the nonprogression CS group (7 of 16 [43.8%]) (Cramer <jats:italic>V<\/jats:italic>, 0.2; 95% CI, 0.01-0.5). The 5-year OS was 100% (95% CI, 100%-100%) in both the disease-progression CS cohort and the IS cohort. Although the cohort of patients undergoing CS after disease progression was by definition a subset with more aggressive tumor behavior, no clinically meaningful differences were observed in the rates of regional recurrence (2 of 39 [5.1%] vs 0 of 39 patients with IS), local recurrence (0 patients), distant metastasis (0 patients), or disease-specific mortality (0 patients) when compared with the matched IS group. Five-year RFS rates were similar: 100% in the IS group and 86% (95% CI, 70%-100%) in the CS group.<\/jats:p><\/jats:sec><jats:sec id=\"ab-ooi240040-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this cohort study, CS for suspected disease progression was associated with surgical and oncologic outcomes similar to IS, supporting the feasibility and safety of AS for patients with low-risk papillary thyroid carcinoma.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaoto.2024.1699","type":"journal-article","created":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T21:30:31Z","timestamp":1715808631000},"page":"1058","source":"Crossref","is-referenced-by-count":14,"title":["Outcomes of Conversion Surgery for Patients With Low-Risk Papillary Thyroid Carcinoma"],"prefix":"10.1001","volume":"150","author":[{"given":"Helena","family":"Levyn","sequence":"first","affiliation":[{"name":"Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel W.","family":"Scholfield","sequence":"additional","affiliation":[{"name":"Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alana","family":"Eagan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillian A.","family":"Boe","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashok R.","family":"Shaha","sequence":"additional","affiliation":[{"name":"Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jatin P.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Ganly","sequence":"additional","affiliation":[{"name":"Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc G. T.","family":"Morris","sequence":"additional","affiliation":[{"name":"Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Michael","family":"Tuttle","sequence":"additional","affiliation":[{"name":"Endocrinology Service, Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"10061","key":"ooi240040r1","doi-asserted-by":"publisher","first-page":"2783","DOI":"10.1016\/S0140-6736(16)30172-6","article-title":"Thyroid cancer.","volume":"388","author":"Cabanillas","year":"2016","journal-title":"Lancet"},{"issue":"9871","key":"ooi240040r2","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.1016\/S0140-6736(12)62205-3","article-title":"Controversies in primary treatment of low-risk papillary thyroid cancer.","volume":"381","author":"McLeod","year":"2013","journal-title":"Lancet"},{"issue":"7","key":"ooi240040r3","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1056\/NEJMp1604412","article-title":"Worldwide thyroid-cancer epidemic? the increasing impact of 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