{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T23:22:17Z","timestamp":1779924137337,"version":"3.53.1"},"reference-count":23,"publisher":"The Endocrine Society","issue":"8","license":[{"start":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T00:00:00Z","timestamp":1707782400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Active surveillance for papillary thyroid cancer (PTC) meeting criteria for surgical resection is uncommon. Which patients may prove reasonable candidates for this approach is not well defined.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This work aimed to examine the feasibility and safety of active surveillance for patients with known or suspected intrathyroidal PTC up to 4\u2005cm in diameter.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective review was conducted of all consecutive patients who underwent nonoperative active surveillance of suspicious or malignant thyroid nodules over a 20-year period from 2001 to 2021. We included patients with an initial ultrasound\u2013fine-needle aspiration confirming either (a) Bethesda 5 or 6 cytology or (b) a \u201csuspicious\u201d Afirma molecular test. The primary outcomes and measures included the rate of adverse oncologic outcomes (mortality and recurrence), as well as the cumulative incidence of size\/volume growth.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Sixty-nine patients were followed with active surveillance for 1 year or longer (average 55 months), with 26 patients (38%) having nodules 2\u2005cm or larger. No patients were found to develop new-incident occurrence of lymph node or distant metastasis. One patient, however, demonstrated concern for progression to a dedifferentiated cancer on repeat core biopsy 17 years after initial start of nonoperative selection. A total of 21% of patients had an increase in maximum diameter more than 3 mm, while volume increase of 50% or greater was noted in 25% of patients. Thirteen patients ultimately underwent delayed (rescue) surgery, and no disease recurrence was noted after such treatment. Age and initial nodule size were not predictors of nodule growth.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>These data expand consideration of active surveillance of PTC in select patients with intrathyroidal suspected malignancy greater than 1\u2005cm in diameter. Rescue surgery, if required at a later time point, appears effective.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgae082","type":"journal-article","created":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T14:31:50Z","timestamp":1707834710000},"page":"1996-2002","source":"Crossref","is-referenced-by-count":12,"title":["Nonoperative, Active Surveillance of Larger Malignant and Suspicious Thyroid Nodules"],"prefix":"10.1210","volume":"109","author":[{"given":"Benjamin","family":"Altshuler","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital , Boston, MA 02115 , USA"},{"name":"Harvard Medical School , Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6362-3772","authenticated-orcid":false,"given":"Athanasios","family":"Bikas","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, 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02115 , USA"},{"name":"Department of Surgery, Brigham and Women's Hospital , Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew A","family":"Nehs","sequence":"additional","affiliation":[{"name":"Harvard Medical School , Boston, MA 02115 , USA"},{"name":"Department of Surgery, Brigham and Women's Hospital , Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason B","family":"Liu","sequence":"additional","affiliation":[{"name":"Harvard Medical School , Boston, MA 02115 , USA"},{"name":"Department of Surgery, Brigham and Women's Hospital , Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard M","family":"Doherty","sequence":"additional","affiliation":[{"name":"Harvard Medical School , Boston, MA 02115 , USA"},{"name":"Department of Surgery, Brigham and Women's Hospital , Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I\u00f1igo","family":"Landa","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital , Boston, MA 02115 , USA"},{"name":"Harvard Medical School , Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Ahmadi","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital , Boston, MA 02115 , USA"},{"name":"Harvard Medical School , Boston, MA 02115 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1313-2462","authenticated-orcid":false,"given":"Erik K","family":"Alexander","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital , 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