Long-Term Durability of Active Surveillance in Small, Low-Risk Papillary Thyroid Cancer: Age-Related Outcomes and Clinical Implications

Highlight

• Active surveillance (AS) is a effective long-term approach for managing small, low-risk papillary thyroid cancer (PTC).
• Older patients (≥65 years) demonstrate a markedly lower crossover rate to surgery compared to younger counterparts.
• Disease progression and patient preference are the primary reasons for crossover from AS to surgery.
• No thyroid cancer–related deaths or distant metastases occurred during long-term follow-up, underscoring the safety of AS.

Study Background and Disease Burden