This article is more than 5 years old. Information may no longer be current.
Active surveillance appropriate for PTC during pregnancy
Click Here to Manage Email Alerts
Women with papillary thyroid cancer during pregnancy can appropriately be treated with active surveillance and delayed thyroid surgery because there were no clinically relevant changes associated with papillary thyroid cancer during pregnancy, published data show.
Won Bae Kim, MD, PhD, of the division of endocrinology and metabolism, department of internal medicine, Asan Medical Center, University of Ulsan College of Medicine in Korea, and colleagues evaluated 19 women (median age, 33 years) with papillary thyroid cancer (PTC) who delayed thyroid surgery because they were diagnosed with PTC just before or during the early stages of pregnancy to determine the natural course of PTC in pregnant women.
Micro-PTCs were diagnosed in 68.4% of participants; median tumor volume on ultrasound was 0.22 cm2 and mean maximal size of tumors on initial neck ultrasound was 0.91 cm.
There was a median interval of 9.5 months between the initial and follow-up neck ultrasound. A meaningful increase in the maximal tumor diameter was found in 16% of participants and 26% showed a meaningful volume increase.
There was no significant change in tumor size between trimesters during the 6.3 months of follow-up (first vs. second trimester, P = .81; second vs. third trimester, P = .99). Before thyroid surgery, 42.1% of participants receiving thyroid-stimulation hormone suppressive therapy; however, there were no significant differences according to TSH suppression (P = .26). None of the 19 participants without initial cervical lymph node metastasis developed a new lymph node metastasis during pregnancy.
Thyroid surgery was performed in 16 participants after delivery and the median interval of delayed surgery was 11.9 months.
“The results of the serial neck [ultrasound] showed no clinically relevant tumor growth or progression of PTCs in patients during pregnancy,” the researchers wrote. “Delayed thyroid surgery with active surveillance can be considered during pregnancy in PTC patients with or without cervical [lymph node] metastasis. Further comprehensive and larger prospective studies are needed to obtain more definitive evidence for the management of [differentiated thyroid carcinoma] in pregnant women.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts