Elsevier

Surgery

Volume 163, Issue 1, January 2018, Pages 48-52
Surgery

Thyroid
Estimation of the lifetime probability of disease progression of papillary microcarcinoma of the thyroid during active surveillance

https://doi.org/10.1016/j.surg.2017.03.028Get rights and content
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Background

We reported that a minority of patients with low-risk papillary microcarcinoma of the thyroid showed disease progression during active surveillance and that older patients had significantly lower disease progression rates than younger patients. Here, we estimated lifetime (≤85 years old) probabilities of disease progression during active surveillance according to the age at presentation based on age decade-specific disease progression rates.

Methods

From 1993–2013, 1,211 low-risk papillary microcarcinoma patients aged 20–79 years underwent active surveillance at Kuma Hospital. We calculated the disease progression rate at the 10-year point of active surveillance for each age-decade group (20s to 70s) with the Kaplan-Meier method. The lifetime disease progression probability for each age group was calculated as (1 − cumulative probability of progression-free survival calculated with age decade-specific disease progression rates) until the patients reached their 80s (i.e., 85 years on average).

Results

The age decade-specific disease progression rates at 10 years of active surveillance were 36.9% (20s), 13.5% (30s), 14.5% (40s), 5.6% (50s), 6.6% (60s), and 3.5% (70s); the respective lifetime disease progression probabilities were 60.3%, 37.1%, 27.3%, 14.9%, 9.9% and 3.5% according to the age at presentation.

Conclusion

The estimated lifetime disease progression probabilities of papillary microcarcinoma during active surveillance vary greatly according to the age at presentation.

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Presented at the 37th annual meeting of the American Association of Endocrine Surgeons from April 2–4, 2017, Orlando, FL.