Study Protocol of Expanded Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro-EXP)
Background Active surveillance (AS) has emerged as a viable management strategy for low-risk papillary thyroid microcarcinoma (PTMC), following pioneering trials at Kuma Hospital and the Cancer Institute Hospital in Japan. Numerous prospective cohort studies have since validated AS as a management o...
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Korean Endocrine Society
2025-04-01
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| author | Jae Hoon Moon Eun Kyung Lee Wonjae Cha Young Jun Chai Sun Wook Cho June Young Choi Sung Yong Choi A Jung Chu Eun-Jae Chung Yul Hwangbo Woo-Jin Jeong Yuh-Seog Jung Kyungsik Kim Min Joo Kim Su-jin Kim Woochul Kim Yoo Hyung Kim Chang Yoon Lee Ji Ye Lee Kyu Eun Lee Young Ki Lee Hunjong Lim Do Joon Park Sue K. Park Chang Hwan Ryu Junsun Ryu Jungirl Seok Young Shin Song Ka Hee Yi Hyeong Won Yu Eleanor White Katerina Mastrocostas Roderick J. Clifton-Bligh Anthony Glover Matti L. Gild Ji-hoon Kim Young Joo Park |
| author_facet | Jae Hoon Moon Eun Kyung Lee Wonjae Cha Young Jun Chai Sun Wook Cho June Young Choi Sung Yong Choi A Jung Chu Eun-Jae Chung Yul Hwangbo Woo-Jin Jeong Yuh-Seog Jung Kyungsik Kim Min Joo Kim Su-jin Kim Woochul Kim Yoo Hyung Kim Chang Yoon Lee Ji Ye Lee Kyu Eun Lee Young Ki Lee Hunjong Lim Do Joon Park Sue K. Park Chang Hwan Ryu Junsun Ryu Jungirl Seok Young Shin Song Ka Hee Yi Hyeong Won Yu Eleanor White Katerina Mastrocostas Roderick J. Clifton-Bligh Anthony Glover Matti L. Gild Ji-hoon Kim Young Joo Park |
| author_sort | Jae Hoon Moon |
| collection | DOAJ |
| description | Background Active surveillance (AS) has emerged as a viable management strategy for low-risk papillary thyroid microcarcinoma (PTMC), following pioneering trials at Kuma Hospital and the Cancer Institute Hospital in Japan. Numerous prospective cohort studies have since validated AS as a management option for low-risk PTMC, leading to its inclusion in thyroid cancer guidelines across various countries. From 2016 to 2020, the Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) enrolled 1,177 patients, providing comprehensive data on PTMC progression, sonographic predictors of progression, quality of life, surgical outcomes, and cost-effectiveness when comparing AS to immediate surgery. The second phase of MAeSTro (MAeSTro-EXP) expands AS to low-risk papillary thyroid carcinoma (PTC) tumors larger than 1 cm, driven by the hypothesis that overall risk assessment outweighs absolute tumor size in surgical decision-making. Methods This protocol aims to address whether limiting AS to tumors smaller than 1 cm may result in unnecessary surgeries for low-risk PTCs detected during their rapid initial growth phase. By expanding the AS criteria to include tumors up to 1.5 cm, while simultaneously refining and standardizing the criteria for risk assessment and disease progression, we aim to minimize overtreatment and maintain rigorous monitoring to improve patient outcomes. Conclusion This study will contribute to optimizing AS guidelines and enhance our understanding of the natural course and appropriate management of low-risk PTCs. Additionally, MAeSTro-EXP involves a multinational collaboration between South Korea and Australia. This cross-country study aims to identify cultural and racial differences in the management of low-risk PTC, thereby enriching the global understanding of AS practices and their applicability across diverse populations. |
| format | Article |
| id | doaj-art-ed628b8af30e4d5da7ae72f4c34bc0c6 |
| institution | OA Journals |
| issn | 2093-596X 2093-5978 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Korean Endocrine Society |
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| series | Endocrinology and Metabolism |
| spelling | doaj-art-ed628b8af30e4d5da7ae72f4c34bc0c62025-08-20T02:14:15ZengKorean Endocrine SocietyEndocrinology and Metabolism2093-596X2093-59782025-04-0140223624610.3803/EnM.2024.21362584Study Protocol of Expanded Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro-EXP)Jae Hoon Moon0Eun Kyung Lee1Wonjae Cha2Young Jun Chai3Sun Wook Cho4June Young Choi5Sung Yong Choi6A Jung Chu7Eun-Jae Chung8Yul Hwangbo9Woo-Jin Jeong10Yuh-Seog Jung11Kyungsik Kim12Min Joo Kim13Su-jin Kim14Woochul Kim15Yoo Hyung Kim16Chang Yoon Lee17Ji Ye Lee18Kyu Eun Lee19Young Ki Lee20Hunjong Lim21Do Joon Park22Sue K. Park23Chang Hwan Ryu24Junsun Ryu25Jungirl Seok26Young Shin Song27Ka Hee Yi28Hyeong Won Yu29Eleanor White30Katerina Mastrocostas31Roderick J. Clifton-Bligh32Anthony Glover33Matti L. Gild34Ji-hoon Kim35Young Joo Park36 Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea Department of Internal Medicine, National Cancer Center, Goyang, Korea Department of Otorhinolaryngology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea Center for Thyroid Cancer, National Cancer Center, Goyang, Korea Department of Radiology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea Department of Otorhinolaryngology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Internal Medicine, National Cancer Center, Goyang, Korea Department of Otorhinolaryngology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea Center for Thyroid Cancer, National Cancer Center, Goyang, Korea Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Center for Thyroid Cancer, National Cancer Center, Goyang, Korea Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Internal Medicine, National Cancer Center, Goyang, Korea Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea Center for Thyroid Cancer, National Cancer Center, Goyang, Korea Center for Thyroid Cancer, National Cancer Center, Goyang, Korea Department of Otorhinolaryngology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea Faculty of Medicine and Health, University of Sydney, Camperdown, Sydney, Australia Department of Radiology, Royal North Shore Hospital, Sydney, Australia Faculty of Medicine and Health, University of Sydney, Camperdown, Sydney, Australia Faculty of Medicine and Health, University of Sydney, Camperdown, Sydney, Australia Faculty of Medicine and Health, University of Sydney, Camperdown, Sydney, Australia Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, KoreaBackground Active surveillance (AS) has emerged as a viable management strategy for low-risk papillary thyroid microcarcinoma (PTMC), following pioneering trials at Kuma Hospital and the Cancer Institute Hospital in Japan. Numerous prospective cohort studies have since validated AS as a management option for low-risk PTMC, leading to its inclusion in thyroid cancer guidelines across various countries. From 2016 to 2020, the Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) enrolled 1,177 patients, providing comprehensive data on PTMC progression, sonographic predictors of progression, quality of life, surgical outcomes, and cost-effectiveness when comparing AS to immediate surgery. The second phase of MAeSTro (MAeSTro-EXP) expands AS to low-risk papillary thyroid carcinoma (PTC) tumors larger than 1 cm, driven by the hypothesis that overall risk assessment outweighs absolute tumor size in surgical decision-making. Methods This protocol aims to address whether limiting AS to tumors smaller than 1 cm may result in unnecessary surgeries for low-risk PTCs detected during their rapid initial growth phase. By expanding the AS criteria to include tumors up to 1.5 cm, while simultaneously refining and standardizing the criteria for risk assessment and disease progression, we aim to minimize overtreatment and maintain rigorous monitoring to improve patient outcomes. Conclusion This study will contribute to optimizing AS guidelines and enhance our understanding of the natural course and appropriate management of low-risk PTCs. Additionally, MAeSTro-EXP involves a multinational collaboration between South Korea and Australia. This cross-country study aims to identify cultural and racial differences in the management of low-risk PTC, thereby enriching the global understanding of AS practices and their applicability across diverse populations.http://e-enm.org/upload/pdf/enm-2024-2136.pdfthyroid cancer, papillarywatchful waitingimmediate surgerystudy protocol |
| spellingShingle | Jae Hoon Moon Eun Kyung Lee Wonjae Cha Young Jun Chai Sun Wook Cho June Young Choi Sung Yong Choi A Jung Chu Eun-Jae Chung Yul Hwangbo Woo-Jin Jeong Yuh-Seog Jung Kyungsik Kim Min Joo Kim Su-jin Kim Woochul Kim Yoo Hyung Kim Chang Yoon Lee Ji Ye Lee Kyu Eun Lee Young Ki Lee Hunjong Lim Do Joon Park Sue K. Park Chang Hwan Ryu Junsun Ryu Jungirl Seok Young Shin Song Ka Hee Yi Hyeong Won Yu Eleanor White Katerina Mastrocostas Roderick J. Clifton-Bligh Anthony Glover Matti L. Gild Ji-hoon Kim Young Joo Park Study Protocol of Expanded Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro-EXP) Endocrinology and Metabolism thyroid cancer, papillary watchful waiting immediate surgery study protocol |
| title | Study Protocol of Expanded Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro-EXP) |
| title_full | Study Protocol of Expanded Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro-EXP) |
| title_fullStr | Study Protocol of Expanded Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro-EXP) |
| title_full_unstemmed | Study Protocol of Expanded Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro-EXP) |
| title_short | Study Protocol of Expanded Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro-EXP) |
| title_sort | study protocol of expanded multicenter prospective cohort study of active surveillance on papillary thyroid microcarcinoma maestro exp |
| topic | thyroid cancer, papillary watchful waiting immediate surgery study protocol |
| url | http://e-enm.org/upload/pdf/enm-2024-2136.pdf |
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