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Optimal Treatment for Papillary Microcarcinoma

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Controversies in Thyroid Surgery

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Abstract

The dramatic increase in the detection and diagnosis of papillary microcarcinomas has resulted in a huge increase in the number of thyroid cancer surgeries being done for very low-risk disease. While thyroid surgery is the cornerstone of the management of clinically significant thyroid cancer, the very low-risk nature of papillary microcarcinoma and the successful use of an active surveillance management approach by our Japanese colleagues have caused many clinicians and patients to question whether or not an immediate surgical approach to initial management is warranted in all cases. In this chapter we will review the risk factors associated with disease progression in papillary microcarcinoma, the expected outcomes after surgical resection, and the outcomes associated with active surveillance. Finally, we will provide clinical guidance with regard to proper selection of patients for either an immediate surgical management approach or an active surveillance observational management approach to very low-risk thyroid cancer.

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Disclosures

The authors have no relevant conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of Endocrinology and Diabetes, The Alfred, 55 Commercial Road, Melbourne, VIC, 3004, Australia

    Mark D. Pace M.B.B.S., F.R.A.C.P.

  2. Endocrinology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Zuckerman Building, Room 590, 1275 York Avenue, New York, NY, 10021, USA

    R. Michael Tuttle M.D.

Authors
  1. Mark D. Pace M.B.B.S., F.R.A.C.P.
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  2. R. Michael Tuttle M.D.
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Correspondence to R. Michael Tuttle M.D. .

Editor information

Editors and Affiliations

  1. Department of Surgery; University of Virginia Health System, C Bruce Morton Professor and Chief; Division of General Surgery, Charlottesville, Virginia, USA

    John B. Hanks

  2. Chairman Department of Surgery, Mount Sinai Beth Israel, Eugene W Friedman Professor of Surgery; Icahn School of Medicine at Mount Sinai, New York, New York, USA

    William B. Inabnet III

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Pace, M.D., Tuttle, R.M. (2016). Optimal Treatment for Papillary Microcarcinoma. In: Hanks, J., Inabnet III, W. (eds) Controversies in Thyroid Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-20523-6_10

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  • DOI: https://doi.org/10.1007/978-3-319-20523-6_10

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-20522-9

  • Online ISBN: 978-3-319-20523-6

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