{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T18:14:38Z","timestamp":1783448078683,"version":"3.55.0"},"reference-count":12,"publisher":"Bioscientifica","issue":"5","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":2776,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background: Patients with small papillary thyroid carcinomas (PTC) can currently be maintained under active surveillance (AS). The recommended criteria are the following: adult individual, tumor \u22641 cm and not adjacent to the trachea or recurrent laryngeal nerve, cytology non-suggestive of the aggressive subtype, absence of lymph node (LN) involvement and extrathyroidal extension (ETE) on ultrasonography (US), and absence of clinical distant metastases. This study aimed to evaluate the frequency of the following peri- and postoperative findings in patients who met the criteria for PTC being candidate for AS: tumor &amp;gt; 1 cm, aggressive subtype or vascular invasion, ETE, clinical LN metastases (cN1), and distant metastases. Methods: We reviewed the results of peri- and postoperative evaluation and histology of patients with a preoperative diagnosis of PTC who would currently be candidates for AS. Results: There were 124 patients (102 women) with nodules \u22641 cm (range 4\u201310 mm). All nodules corresponded to papillary microcarcinomas on histology and none of them were &amp;gt; 1 cm. Only one microcarcinoma (0.8%) was of the tall-cell subtype. Vascular invasion was found in 10 microcarcinomas (8%). None of the microcarcinomas were staged as T3b or T4, although microscopic ETE was observed in 25 tumors (20%). In 8 patients (6.4%), central LN involvement was suspected during perioperative\u00a0evaluation and was confirmed by histology (cN1a). None of the patients had distant metastases (M0). Conclusion: Findings that define an intermediate risk of recurrence and favor total thyroidectomy were observed in 31.5% of patients with PTC who are candidates for AS.<\/jats:p>","DOI":"10.1159\/000490701","type":"journal-article","created":{"date-parts":[[2018,7,13]],"date-time":"2018-07-13T17:03:41Z","timestamp":1531501421000},"page":"258-261","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-17","source":"Crossref","is-referenced-by-count":1,"title":["Are Papillary Thyroid Carcinomas That Are Candidates for Active Surveillance in Fact Classical Microcarcinomas Restricted to the Gland?"],"prefix":"10.1530","volume":"7","author":[{"given":"Pedro\u00a0Weslley\u00a0Souza","family":"Rosario","sequence":"first","affiliation":[{"name":"1Santa Casa de Belo Horizonte, Belo Horizonte, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela\u00a0Franco","family":"Mour\u00e3o","sequence":"additional","affiliation":[{"name":"1Santa Casa de Belo Horizonte, Belo Horizonte, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro\u00a0Henrique\u00a0Lopes","family":"Oliveira","sequence":"additional","affiliation":[{"name":"1Santa Casa de Belo Horizonte, Belo Horizonte, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tulio\u00a0Henrique","family":"Silva","sequence":"additional","affiliation":[{"name":"1Santa Casa de Belo Horizonte, Belo Horizonte, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2018,7,13]]},"reference":[{"key":"2026070712555190500_ref1","doi-asserted-by":"crossref","unstructured":"Ito Y, Miyauchi A, Kihara M, Higashiyama T, Kobayashi K, Miya A: Patient age is significantly related to the progression of papillary microcarcinoma of the thyroid under observation. Thyroid 2014; 24: 27\u201334.","DOI":"10.1089\/thy.2013.0367"},{"key":"2026070712555190500_ref2","doi-asserted-by":"crossref","unstructured":"Fukuoka O, Sugitani I, Ebina A, Toda K, Kawabata K, Yamada K: Natural history of asymptomatic papillary thyroid microcarcinoma: time-dependent changes in calcification and vascularity during active surveillance. World J Surg 2016; 40: 529\u2013537.","DOI":"10.1007\/s00268-015-3349-1"},{"key":"2026070712555190500_ref3","doi-asserted-by":"crossref","unstructured":"Kwon H, Oh HS, Kim M, Park S, Jeon MJ, Kim WG, Kim WB, Shong YK, Song DE, Baek JH, Chung KW, Kim TY: Active surveillance for patients with papillary thyroid microcarcinoma: a single center\u2019s experience in Korea. J Clin Endocrinol Metab 2017; 102: 1917\u20131925.","DOI":"10.1210\/jc.2016-4026"},{"key":"2026070712555190500_ref4","doi-asserted-by":"crossref","unstructured":"Tuttle RM, Fagin JA, Minkowitz G, Wong RJ, Roman B, Patel S, Untch B, Ganly I, Shaha AR, Shah JP, Pace M, Li D, Bach A, Lin O, Whiting A, Ghossein R, Landa I, Sabra M, Boucai L, Fish S, Morris LGT: Natural history and tumor volume kinetics of papillary thyroid cancers during active surveillance. JAMA Otolaryngol Head Neck Surg 2017; 143: 1015\u20131020.","DOI":"10.1001\/jamaoto.2017.1442"},{"key":"2026070712555190500_ref5","doi-asserted-by":"crossref","unstructured":"Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L: 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 2016; 26: 1\u2013133.","DOI":"10.1089\/thy.2015.0020"},{"key":"2026070712555190500_ref6","doi-asserted-by":"crossref","unstructured":"Russ G, Bonnema SJ, Erdogan MF, Durante C, Ngu R, Leenhardt L: European thyroid association guidelines for ultrasound malignancy risk stratification of thyroid nodules in adults: the EU-TIRADS. Eur Thyroid J 2017; 6: 225\u2013237.","DOI":"10.1159\/000478927"},{"key":"2026070712555190500_ref7","doi-asserted-by":"crossref","unstructured":"Kwak JY, Kim EK, Youk JH, Kim MJ, Son EJ, Choi SH, Oh KK: Extrathyroid extension of well-differentiated papillary thyroid microcarcinoma on US. Thyroid 2008; 18: 609\u2013614.","DOI":"10.1089\/thy.2007.0345"},{"key":"2026070712555190500_ref8","doi-asserted-by":"crossref","unstructured":"Shin JH, Baek JH, Chung J, Ha EJ, Kim JH, Lee YH, Lim HK, Moon WJ, Na DG, Park JS, Choi YJ, Hahn SY, Jeon SJ, Jung SL, Kim DW, Kim EK, Kwak JY, Lee CY, Lee HJ, Lee JH, Lee JH, Lee KH, Park SW, Sung JY; Korean Society of Thyroid Radiology (KSThR) and Korean Society of Radiology: Ultrasonography diagnosis and imaging-based management of thyroid nodules: revised Korean society of thyroid radiology consensus statement and recommendations. Korean J Radiol 2016; 17: 370\u2013395.","DOI":"10.3348\/kjr.2016.17.3.370"},{"key":"2026070712555190500_ref9","doi-asserted-by":"crossref","unstructured":"Ros\u00e1rio PW, de Faria S, Bicalho L, Alves MF, Borges MA, Purisch S, Padr\u00e3o EL, Rezende LL, Barroso AL: Ultrasonographic differentiation between metastatic and benign lymph nodes in patients with papillary thyroid carcinoma. J Ultrasound Med 2005; 24: 1385\u20131389.","DOI":"10.7863\/jum.2005.24.10.1385"},{"key":"2026070712555190500_ref10","doi-asserted-by":"crossref","unstructured":"Ros\u00e1rio PW, Tavares WC, Borges MA, Santos JB, Calsolari MR: Ultrasonographic differentiation of cervical lymph nodes in patients with papillary thyroid carcinoma after thyroidectomy and radioiodine ablation: a prospective study. Endocr Pract 2014; 20: 293\u2013298.","DOI":"10.4158\/EP13307.OR"},{"key":"2026070712555190500_ref11","unstructured":"Tuttle M, Morris LF, Haugen B, et al: AJCC Cancer Staging Manual; In Amin MB, Edge SB, Greene FL (eds): ed 8. Springer, New York, NY, 2017, pp 1\u201319."},{"key":"2026070712555190500_ref12","doi-asserted-by":"crossref","unstructured":"Lang BH, Shek TW, Wan KY: The significance of unrecognized histological high-risk features on response to therapy in papillary thyroid carcinoma measuring 1\u20134 cm: implications for completion thyroidectomy following lobectomy. 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