ABSTRACT
Active surveillance ( AS ) is now regarded as an alternative strategy of treatment for papillary thyroid microcarcinoma ( PTMC) . Most cases of newly diagnosed thyroid cancer are small indolent microcarcinoma and could be good candidates for AS instead of immediate surgery. Many considerations must be taken into account for establishing selection criteria suitable for AS of PTMC, including the characteristics of the tumor, the patient, and the medical team. If possible, AS of PTMC should be a part of a prospective clinical trial to ensure long-term safety and to identify clinical and ( or) molecular markers of the progression of PTMC. In this review, we discuss lessons regarding surgical interventions for PTMC, and then describe the concept, application, caveats, unanswered questions, and future perspectives of AS for PTMC. For appropriately selected patients with PTMC, AS can be a good alternative to immediate surgery.