{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T07:54:06Z","timestamp":1789458846271,"version":"build-2803163510"},"reference-count":35,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>During active surveillance (AS) of low-risk papillary thyroid carcinomas (PTCs), the majority remain stable, while some exhibit either an increase or a decrease in tumor diameter or tumor volume (TV). We aimed to evaluate the clinical outcomes and relevant parameters influencing tumor growth kinetics of low-risk PTCs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective cohort study evaluated clinical parameters of 402 patients with low-risk PTC sized &lt;2 cm, with a follow-up duration over 3 years. Changes in maximum tumor diameter, TV, and initial TV doubling time (i-TVDT) calculated within 3 years were assessed. A significant change in TV was defined as a change of 75% or more.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of the 402 patients with low-risk PTC, 93.3% (375\/402) were diagnosed with papillary thyroid microcarcinoma. During a median follow-up of 5 years, 3.4% (14\/402) of patients developed new cervical lymph node (LN) metastasis, and 8.2% (33\/402) experienced a maximal diameter increase of \u22653 mm. The i-TVDT of &lt;5 years emerged as an independent risk factor for both maximal diameter growth and new LN metastasis (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001 and\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.04, respectively). Based on TV changes and i-TVDT during AS, we identified four statistically significant tumor kinetic patterns (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001): Stable (\u00b175% change in TV), Rapid growth (TV increase &gt;75% and i-TVDT &lt;5 years), Slow growth (TV increase &gt;75% and i-TVDT \u22655 years), and Shrinkage (TV decrease &gt;75%). Most of the PTCs remained stable (67.7%), but 17.2% were rapidly growing, with a median onset of growth of 2.0 years. Slowly growing PTCs, comprising 10.9%, grew at a median of 4.3 years. A minority, 4.2%, exhibited shrinkage. In total, 115 (28.6%) patients underwent delayed surgery &gt;12 months after initiating AS. The reasons for delayed surgery included patient preference (51\/115, 44.3%), disease progression (31\/115, 27.0%), and suspected disease progression, which was referred to as tumor growth not meeting the criteria of an increase of \u22653 mm in maximal tumor diameter (17\/115, 14.8%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>An i-TVDT of &lt;5 years serves as an important prognostic indicator for disease progression, including tumor growth and new LN metastasis. The four tumor kinetic patterns based on TV changes and i-TVDT assist in guiding personalized decisions early in AS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/thy.2024.0054","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T07:11:37Z","timestamp":1715929897000},"page":"846-855","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Tumor Growth Kinetics Based on Initial Tumor Volume Doubling Time in Active Surveillance of Low-Risk Papillary Thyroid Carcinoma"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3921-8635","authenticated-orcid":false,"given":"Chae A","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Hee","family":"Baek","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Biostatics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5074-3561","authenticated-orcid":false,"given":"Jungmin","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sae Rom","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Hwan","family":"Baek","sequence":"additional","affiliation":[{"name":"Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ki-Wook","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won Bae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1297-107X","authenticated-orcid":false,"given":"Min Ji","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8404-7759","authenticated-orcid":false,"given":"Won Gu","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of 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