Anna M. Sawka<\/b><\/strong><\/p>\n<\/div>\n Sawka and colleagues conducted a prospective cohort study of adults aged at least 18 years diagnosed with papillary thyroid cancer with a tumor less than 2 cm in diameter. Adults who chose active surveillance attended a follow-up every 6 months for 2 years, followed by annually thereafter. Patients who initially chose active surveillance could undergo surgery at any point. <\/p>\n
There were 120 patients in the study, of whom 98 initially chose active surveillance and 22 underwent surgery immediately after diagnosis (median age, 53 years; 74% women). Of adults in the active surveillance group, 16 later underwent surgery, with eight having surgery following disease progression, seven opting for surgery by choice and one patient having surgery due to uncertainty in tumor measurement.<\/p>\n
Adults who chose active surveillance had similar patient-reported outcome scores as those who underwent surgery in all questionnaires.<\/p>\n
On the Assessment of Survivor Concerns questionnaire, adults who switched from active surveillance to surgery had higher cancer worry scores (mean score, 7.5 points) vs. those who underwent surgery at baseline (mean score, 5.6 points) and those who remained in active surveillance (mean score, 5.4 points; P<\/i> = .021). Similarly, overall worry summary score on the questionnaire was higher for those changing from active surveillance to surgery than the other two groups (P<\/i> = .021).<\/p>\n
Sawka said the increased worry for patients who switched treatment options was not surprising, noting that some patients had cancer progression that may have increased worry, whereas others may have changed their mind due to continued cancer concerns, even in the absence of progression.<\/p>\n
\u201cIt will be important to continue to follow the patients who crossed over with longer-term follow-up to ascertain whether their level of worry and decision regret improve over time,\u201d Sawka said.<\/p>\n
Adults who switched from active surveillance to surgery reported feeling a greater level regret about their treatment decision (mean score, 27.2 points) than those who had surgery at diagnosis (mean score, 21.1 points) and adults who remained in active surveillance (mean score, 17.9 points; P<\/i> = .031). In post hoc exploratory analysis, seven adults who chose to switch from active surveillance to surgery without disease progression had higher decision regret scores than the eight adults who switched to surgery due to cancer progression (38.9 points vs. 19 points). Other patient-reported outcomes did not differ between those two groups.<\/p>\n
Sawka said large, prospective studies need to be conducted to confirm the findings.<\/p>\n
For more information:<\/h2>\n Anna M. Sawka, MD, PhD<\/b>,<\/b> can be reached at endocrinology@healio.com.<\/p>\n\n
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