{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T18:15:41Z","timestamp":1793124941230,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","award":["202040019"],"award-info":[{"award-number":["202040019"]}],"id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The rising detection rate of papillary thyroid microcarcinoma (PTMC) necessitates effective management strategies to prevent overtreatment. Active surveillance (AS) has emerged as a potential solution; however, its applicability and cost\u2010effectiveness within China's healthcare system need further investigation. This study aims to evaluate the feasibility and economic benefits of AS for Chinese patients with PTMC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective study enrolled 145 PTMC patients at Ruijin Hospital, Shanghai. We analyzed progression risk factors and compared 5\u2010year medical costs between AS and immediate surgery (IS), employing SPSS 26 and R for Kaplan\u2013Meier and COX survival analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 145 participants, 105 completed the study. According to the Kaplan\u2013Meier analysis, the cumulative progression rate in our study was 13% (95% CI: 0.05\u20130.20) over 35\u00a0months. Among these patients, 26 underwent surgery, and a higher lymph node metastasis rate was observed in patients with disease progression (61.5%) compared to those without progression (7.7%). Risk factors for PTMC progression included calcification, age, and tumor size. Economically, AS was theoretically more cost\u2010effective than IS. The medical expense of IS with subsequent 5 years follow\u2010up was approximately 6 times higher than that of a 5\u2010year regimen of AS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AS is a cost\u2010effective option for managing low\u2010risk PTMC in China. High resolution ultrasonography allowed to detect disease progression. Patients younger than 40\u00a0years, the presence of initial tumor microcalcifications, and tumor size exceeding 7\u00a0mm were significantly associated with disease progression. Further validation of these findings is needed with larger sample sizes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.12551","type":"journal-article","created":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T23:29:25Z","timestamp":1743118165000},"page":"1246-1253","source":"Crossref","is-referenced-by-count":5,"title":["Active Surveillance for Low\u2010Risk Papillary Thyroid Microcarcinoma in China: A Prospective Study on Progression, Influencing Factors, and Cost\u2010Effectiveness"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6023-6522","authenticated-orcid":false,"given":"Yuxin","family":"Ge","sequence":"first","affiliation":[{"name":"Department of General Practice Ruijin Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Ruijin Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Ruijin Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0964-8407","authenticated-orcid":false,"given":"Jianqiao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Ruijin Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianjing","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of General Practice Ruijin Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Endocrinology &amp; Metabolic Diseases Ruijin Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonggang","family":"He","sequence":"additional","affiliation":[{"name":"Department of General Surgery Zhoupu Hospital Shanghai University of Medicine and Health Sciences  Shanghai China"},{"name":"Department of General Surgery Ruijin Hospital, Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29251"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2014.1"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1409841"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010014\u20103846\u20108"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2011.0139"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0178"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010009\u20100359\u2010x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2022.0444"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ22\u20100559"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.20892\/j.issn.2095\u20103941.2017.0051"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.888072"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2020.571421"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41571\u2010018\u20100116\u2010x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010009\u20100303\u20100"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016\u20104026"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.20892\/j.issn.2095\u20103941.2021.0058"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2023.04.016"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ16\u20100097"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010021\u201006185\u20102"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2023.0076"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2013.0367"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2020.0368"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010016\u20103437\u2010x"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2018.0609"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010015\u20103392\u2010y"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010015\u20103184\u20104"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.EJ16\u20100381"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2023.0058"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2017.0448"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.12551","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/wjs.12551","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.12551","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T16:31:35Z","timestamp":1771259495000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/wjs.12551"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,27]]},"references-count":29,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1002\/wjs.12551"],"URL":"https:\/\/doi.org\/10.1002\/wjs.12551","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,27]]}}}