Endocrinology and metabolism (Seoul, Korea) · 2025
Study Protocol of Expanded Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro-EXP).
Протокол клинического исследованияСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Moon Jae Hoon, Lee Eun Kyung, Cha Wonjae, Chai Young Jun, Cho Sun Wook, Choi June Young, Choi Sung Yong, Chu A Jung, Chung Eun-Jae, Hwangbo Yul, Jeong Woo-Jin, Jung Yuh-Seog, Kim Kyungsik, Kim Min Joo, Kim Su-Jin, Kim Woochul, Kim Yoo Hyung, Lee Chang Yoon, Lee Ji Ye, Lee Kyu Eun, Lee Young Ki, Lim Hunjong, Park Do Joon, Park Sue K, Ryu Chang Hwan, Ryu Junsun, Seok Jungirl, Song Young Shin, Yi Ka Hee, Yu Hyeong Won, White Eleanor, Mastrocostas Katerina, Clifton-Bligh Roderick J, Glover Anthony, Gild Matti L, Kim Ji-Hoon, Park Young Joo
Аннотация
BACKGROUND: Active surveillance (AS) has emerged as a viable management strategy for low-risk papillary thyroid microcarcinoma (PTMC), following pioneering trials at Kuma Hospital and the Cancer Institute Hospital in Japan. Numerous prospective cohort studies have since validated AS as a management option for low-risk PTMC, leading to its inclusion in thyroid cancer guidelines across various countries. From 2016 to 2020, the Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) enrolled 1,177 patients, providing comprehensive data on PTMC progression, sonographic predictors of progression, quality of life, surgical outcomes, and cost-effectiveness when comparing AS to immediate surgery. The second phase of MAeSTro (MAeSTro-EXP) expands AS to low-risk papillary thyroid carcinoma (PTC) tumors larger than 1 cm, driven by the hypothesis that overall risk assessment outweighs absolute tumor size in surgical decision-making.
METHODS: This protocol aims to address whether limiting AS to tumors smaller than 1 cm may result in unnecessary surgeries for low-risk PTCs detected during their rapid initial growth phase. By expanding the AS criteria to include tumors up to 1.5 cm, while simultaneously refining and standardizing the criteria for risk assessment and disease progression, we aim to minimize overtreatment and maintain rigorous monitoring to improve patient outcomes.
CONCLUSION: This study will contribute to optimizing AS guidelines and enhance our understanding of the natural course and appropriate management of low-risk PTCs. Additionally, MAeSTro-EXP involves a multinational collaboration between South Korea and Australia. This cross-country study aims to identify cultural and racial differences in the management of low-risk PTC, thereby enriching the global understanding of AS practices and their applicability across diverse populations.
METHODS: This protocol aims to address whether limiting AS to tumors smaller than 1 cm may result in unnecessary surgeries for low-risk PTCs detected during their rapid initial growth phase. By expanding the AS criteria to include tumors up to 1.5 cm, while simultaneously refining and standardizing the criteria for risk assessment and disease progression, we aim to minimize overtreatment and maintain rigorous monitoring to improve patient outcomes.
CONCLUSION: This study will contribute to optimizing AS guidelines and enhance our understanding of the natural course and appropriate management of low-risk PTCs. Additionally, MAeSTro-EXP involves a multinational collaboration between South Korea and Australia. This cross-country study aims to identify cultural and racial differences in the management of low-risk PTC, thereby enriching the global understanding of AS practices and their applicability across diverse populations.