Age-and Sex-Specific Impact on the Progression of Low-risk Papillary Thyroid Carcinoma Under Active Surveillance: A meta-analysis

Li Wang^*

• Zhuhai People's Hospital, Zhuhai, China

BackgroundThe global incidence of papillary thyroid carcinomas (PTC) is increasing significantly. In response, active surveillance (AS) has been promoted for Low-risk PTC due to the absence of associated mortality. However, the association between age, sex, and the risk of tumor progression remains unclear. This study aims to assess the age- and sex-specific Impact on the progression of low-risk PTC under AS.MethodsPubMed and Web of Science Core Collection were searched up to January 1, 2024. Articles reporting on patients with PTC under AS were included. Studies that involved patients with total or partial thyroidectomy and radiofrequency ablation were excluded. Random and fixed-effect models were applied to obtain pooled proportions and 95% CIs. ResultsA total of 972 unique citations were screened, and 39 full-text articles were reviewed, ultimately including 8 cohorts. The mean or median age ranged from 41.5 to 53.1 years, with a predominant inclusion of female patients (76.39%-87.80%). The pooled risk ratio for tumor progression (a growth of 3 mm or more in maximal diameter or lymph node metastasis) in older adults (aged over 30-50 years) compared with younger individuals was 0.58 (95% CI, 0.47-0.71; 4725 patients, 6 studies). However, for male patients, the pooled risk ratio for tumor progression compared with female individuals was 1.11 (95% CI, 0.64-1.93; 4916 patients, 6 studies).ConclusionThis meta-analysis suggests that advancing age may be associated with a lower risk of progression in papillary thyroid microcarcinomas during active surveillance. No significant differences were observed between genders.