Comparison of Patient-Reported Outcomes Between Active Surveillance and Immediate Lobectomy in Patients with Low-Risk Papillary Thyroid Microcarcinoma: Initial Findings from the KoMPASS Cohort

作者：Min Joo Kim, Hojeong Won, Won Bae Kim, Eun Kyung Lee, Chang Yoon Lee, Sun Wook Cho, Han-Sang Baek, Yong Sang Lee, Yae Eun Kang, Sun Wook Kim, Ho‐Cheol Kang, Jeongmin Lee, Mijin Kim, Min Ji Jeon, Jae Hoon Moon · 发表于：Thyroid · 年份：2024 · DOI：10.1089/thy.2024.0264 · 被引用次数：12 · 研究领域：Thyroid Cancer Diagnosis and Treatment、Thyroid and Parathyroid Surgery

Background: Patients diagnosed with low-risk papillary thyroid microcarcinoma (PTMC) face the decision between thyroid lobectomy and active surveillance (AS). This study aimed to investigate the factors influencing treatment decisions in low-risk PTMC and to compare the quality of life (QoL) according to the treatment plan. Methods: The multicenter prospective cohort study comparing AS and thyroid lobectomy was conducted. Clinical characteristics were compared between the AS and Lobectomy groups. QoL questionnaires were administered every 6 months in the initial year and annually thereafter. Results: A total of 927 patients (453 in the AS group and 474 in the Lobectomy group) with low-risk PTMC were included in this study. The mean age was 47.4 ± 12.2 years, and 72.2% of the patients were women. Older age (odd ratio [OR] 1.04, confidence interval [CI] 1.02–1.05, p < 0.001), smaller tumor size (OR 0.78, CI 0.69–0.87, p < 0.001), family history of thyroid cancer (OR 1.48, CI 1.03–2.12, p = 0.035), prior awareness of AS (OR 1.53, CI 1.16–2.02, p = 0.003), and higher income (OR 1.79, CI 1.13–2.83, p = 0.013) were significantly associated with a higher likelihood of choosing AS. The median follow-up was 27.3 months (23.9–43.9) in the AS group and 28.7 months (20.4–44.5) in the Lobectomy group. During the follow-up period, the AS group showed significantly better QoL scores compared with the Lobectomy group ( β 0.17, CI 0.02–0.33, p = 0.029). Although baseline QoL scores favo...