Published online Jun 24, 2020. doi: 10.5306/wjco.v11.i6.320
Peer-review started: January 15, 2020
First decision: March 15, 2020
Revised: April 7, 2020
Accepted: May 5, 2020
Article in press: May 5, 2020
Published online: June 24, 2020
Core tip: While the diagnosis of intrathyroidal papillary microcarcinomas has increased exponentially, the mortality rate has remained stable. Although surgical resection was the classic standard therapy, active surveillance has emerged as an alternative approach aimed to recognize a minority of patients who will clinically progress and would likely benefit from rescue surgery. During follow-up, these tumors (including those between 1-2 cm) evolve with no changes in size, have very slow growth rates, and even decrease in diameter. Given the high prevalence of papillary microcarcinomas and the excellent observational outcomes, active surveillance constitutes a safe and feasible alternative for properly selected patients.