Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
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perform a molecular testing, or a diagnostic lobectomy, or an active surveillance. Few papers have been published reporting the efficacy of thermo- or microwave ablation in this class of nodules, but only small (volume range: 1.9–7.9 mL) and genetically
Division of Interventional Radiology, European Institute of Oncology, IRCCS, Milan, Italy
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Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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the frequently indolent nature of PTMC and the cost and risk of surgery, active surveillance (AS) and ultrasound (US)-guided minimally invasive treatments (MITs) are proposed as alternative management options to thyroidectomy for selected incidental
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Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
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Department of Pediatric Radiology and Nuclear Medicine, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
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Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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in Children with PHTS Improve Outcome? If early detection of DTC improved outcome, this would be an argument for an active surveillance program. No evidence for improved outcome was found for PHTS children and for children in the International
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studies have suggested that “active surveillance” of select low-risk DTC [ 17 , 27 ] instead of an aggressive initial treatment such as surgery and/or I-131 therapy does not change the outcome in the short to medium term. However, the long-term safety of
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death of the patients in 0.6% of the cases [ 7 - 11 ] . The management of PMC in the literature may vary from active surveillance without surgery in selected patients to a total thyroidectomy with or without radioactive iodine treatment [ 12 ]. Lobectomy
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with surgery, active surveillance, or local treatment, depending on the size of the nodule ( 3 , 4 , 5 , 6 ). Given the high rate of thyroid nodules, most of which are benign, to reduce fine needle aspiration cytology (FNAC) and unnecessary surgery
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distant metastases were detected. Therefore, an active surveillance strategy was chosen. At the following evaluation (June 2020) CTN values increased (3254 ng/L) and 2 small (<1 cm) suspicious liver metastases were detected by abdomen magnetic resonance
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surveillance of cancer recurrence during the follow-up period in DTC patients [ 4 , 5 ]. However, in many Asian countries including Korea, using rhTSH in those situations is restricted mainly due to its high costs and reimbursement issues [ 6 ]. Given the
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surgical selection. Our study underlines the importance of monitoring implementation of international guidelines, especially in an ever-evolving era of thyroid cancer management, where even active surveillance is increasingly advocated in case of very low
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–benefit ratio ( 5 , 6 , 7 ). A more conservative approach results in reduced cost as well as a lower risk of complications ( 8 , 9 ). Implementation of active surveillance and minimally invasive techniques (MITs) has been limited and measured ( 10