Surgical approaches for papillary microcarcinomas: Turkey’s perspective

Abstract

Objectives: The incidence of papillary microcarcinomas, which are defined as thyroid cancers of <10mm in size,has been increasing in the last decade. Herein, we present internet-based questionnaire results performed by theTurkish Association of Endocrine Surgery with the aim to evaluate the perspective of the management of papillarymicrocarcinomas in Turkey.Material and Methods: The user-friendly questionnaire consisted of 13 questions in total. These questions mainlyaddressed the surgical management of nodules and cancer of <1 cm in size. Patient management before, during,and after surgical intervention was also included, additionally, the “active surveillance approach” was questioned.Results: There were 420 responders in total who were of multidisciplinary origin (endocrinologists, surgeons, nuclearmedicine specialists, pathologists, and oncologists). Total thyroidectomy was the predominant treatment approach(65%) for the classical type of microcarcinoma limited in one lobe, whereas in cases of microcarcinomasincidentally diagnosed during hemithyroidectomy, complementary surgery approach was advised by 40% of theresponders. The responders found capsule invasion (86%) and patient based management (94%) of high importance.The percentage of the responders who recommended radioactive iodine ablation in incidental cancers having noaggressive criteria was 51%. The survey participants that were against routine central dissection in these cases accountedfor 73% of the responders. The recommendation of active surveillance (follow-up without any interventionaltherapy) was limited with 9% responders.Conclusion: The results of the questionnaire demonstrated that there have been various choices in Turkey for thesurgical treatment of the papillary microcarcinomas.