A Seoul National University Bundang Hospital (SNUBH) research team has conducted a large-scale study to demonstrate that patients with low-risk thyroid cancer can maintain their quality of life through active surveillance rather than immediate surgery.
A SNUBH research team, led by Professors Kim Min-joo (right) and Moon Jae-hoon, confirmed patients with low-risk thyroid cancer can maintain their quality of life through active surveillance rather than immediate surgery. (Credit: SNUBH)
A SNUBH research team, led by Professors Kim Min-joo (right) and Moon Jae-hoon, confirmed patients with low-risk thyroid cancer can maintain their quality of life through active surveillance rather than immediate surgery. (Credit: SNUBH)
The study, led by Professors Kim Min-joo and Moon Jae-hoon from the Department of Internal Medicine, was part of a multicenter cohort research project (KoMPASS cohort) involving 11 major hospitals in Korea, including Asan Medical Center.
Conducted under the "Patient-Centered Medical Technology Optimization Research Project," the study systematically analyzed changes in quality of life based on different treatment options for low-risk thyroid cancer patients.
The study included 927 patients diagnosed with low-risk papillary thyroid microcarcinoma (tumors measuring 1 cm or less). After receiving detailed explanations from their physicians, participants chose between immediate surgery and active surveillance. Their quality of life was assessed at treatment initiation and then at six-month, 12-month, and 24-month intervals.
Active surveillance involves regular ultrasound examinations every six to 12 months to monitor tumor size and potential metastasis without immediate surgery.
However, this approach is only applicable under specific conditions, such as the absence of lymph node involvement or local tissue invasion. Physicians must assess each patient’s suitability for this approach, and if tumor progression or metastasis is suspected, surgical treatment may be necessary.
The study found that at the start of treatment, the quality of life score for the active surveillance group was 7.1, higher than the 6.7 recorded for the surgery group. After one year, the scores converged, with active surveillance at 7.2 and surgery at 7.1, indicating a similar quality of life over time.
Patients who opted for active surveillance tended to be older, had smaller tumors, a family history of thyroid cancer, or belonged to higher-income groups. Notably, patients who were already aware of active surveillance before treatment were more likely to choose this option.
“This study shows that for patients with low-risk thyroid cancer, active surveillance can be an effective treatment option alongside surgery,” Professor Kim said. “It challenges the conventional approach of immediate surgery following a cancer diagnosis, empowering patients to make informed decisions through consultation with their healthcare providers.”
Professor Moon also emphasized the importance of offering both surgical and non-surgical options to patients.
“Healthcare professionals must thoroughly explain the advantages and disadvantages of each treatment approach and their impact on quality of life to help patients make the best decision,” he said.
The research team plans to continue long-term observations and further studies on the cost-effectiveness, disease progression rates, and patient satisfaction associated with active surveillance.
The findings of this study were recently published in the latest issue of the journal Thyroid.
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