# Active surveillance of papillary thyroid microcarcinoma at Kuma Hospital: patient age and progression

Source: https://onco.cc/key-papers/paper-ito-kuma-active-surveillance-microcarcinoma-thyroid-2014/  
OnCo record `paper-ito-kuma-active-surveillance-microcarcinoma-thyroid-2014` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Following more than 1,200 patients with small papillary thyroid cancers under observation, the Kuma Hospital group found that only 8 percent grew and under 4 percent developed node metastases over ten years, with the lowest risk in older patients, establishing surveillance as a safe alternative to surgery.

## Summary

Prospective observational cohort of 1,235 patients with low-risk papillary thyroid microcarcinoma managed by active surveillance between 1993 and 2011, analysing tumour enlargement and nodal metastasis by age.

Ten-year rates of tumour enlargement of 3 mm or more and of new node metastases were 8.0 and 3.8 percent; progression was most frequent in patients under 40 and rarest in those over 60, and no patient died of thyroid cancer or developed distant metastases.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: Thyroid
- Year: 2014
- DOI: 10.1089/thy.2013.0367
- Authors: Ito Y, Miyauchi A, Kihara M, et al.
- Findings: Ten-year tumour enlargement 8.0 percent; nodal metastasis 3.8 percent.; Progression more frequent under 40 (about 22 percent at ten years) than over 60 (about 3 percent).
- What it means: Active surveillance is a guideline-endorsed option for papillary microcarcinoma, adopted in Japan, the United States and elsewhere, especially for older patients.
- Caveats: Single-centre Japanese cohort with expert ultrasound; selection excluded tumours near the trachea or nerve.

## Sources

- Thyroid 2014: https://doi.org/10.1089/thy.2013.0367
- PubMed: https://pubmed.ncbi.nlm.nih.gov/24001104/

## Connected records

- cancers: [Papillary thyroid cancer](https://onco.cc/cancers/papillary-thyroid-cancer/)

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