Trends in nonoperative management of papillary thyroid microcarcinoma

Simon A. Holoubek, Huan Yan, Kristine M. Kuchta, David J. Winchester, Tricia A. Moo-Young, Richard A. Prinz

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: In 2010, a Japanese trial of nonoperative management for papillary thyroid microcarcinomas (PTmC) was published. This study determines if the prevalence of nonoperative management in the United States has changed and if there are predictors of this approach. Methods: Patients treated for PTmC between 2004 and 2015 in the National Cancer Data Base were identified. Inclusion criteria were: classic or follicular variant papillary cancer histology, tumor size 1 to 10 mm, cN0 disease and no extrathyroidal extension or metastatic disease. Nonoperative management was assessed over time and compared between 2004-2010 and 2010-2015. Logistic regression identified factors associated with nonoperative management. Results: Of 65 381 PTmC patients, 344 (0.5%) were treated nonoperatively. The annual rate of nonoperative management was similar at 0.6% in 2004 to 0.4% in 2010 (P =.755) but increased to 0.9% in 2015 (P <.001). There was no difference in patient age, race, comorbidities, or reason for nonoperative management between the two periods. Academic centers managed more patients nonoperatively. Multivariable logistic regression suggests older age, facility type, location, Hispanic, Asian, and Native American ethnicity were associated with nonoperative management. Conclusion: The vast majority of PTmC in the United States is treated with an operation. A small but significant increase in nonoperative management occurred between 2004-2010 and 2010-2015.

Original languageEnglish (US)
Pages (from-to)952-957
Number of pages6
JournalJournal of Surgical Oncology
Volume121
Issue number6
DOIs
StatePublished - May 1 2020
Externally publishedYes

Keywords

  • microcarcinoma
  • nonoperative
  • papillary
  • thyroid

ASJC Scopus subject areas

  • Surgery
  • Oncology

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  • Cite this

    Holoubek, S. A., Yan, H., Kuchta, K. M., Winchester, D. J., Moo-Young, T. A., & Prinz, R. A. (2020). Trends in nonoperative management of papillary thyroid microcarcinoma. Journal of Surgical Oncology, 121(6), 952-957. https://doi.org/10.1002/jso.25845