Saravana-Bawan B, et al. - Researchers examined if active surveillance is safe and efficacious for low-risk papillary thyroid carcinoma, defined as T1a or T1b, N0, M0 disease. Searching MEDLINE, EMBASE, and PubMed, they included nine relevant publications with 4,156 patients. During active surveillance, the pooled proportion of tumor growth was 4.4%, the pooled rate of metastatic spread to cervical nodes was 1.0%, and pooled mortality due to thyroid cancer was 0.03%. The pooled proportion of incidence of delayed thyroid surgery was 9.9%. Patient preference, not disease progression, was the main indication for surgery, at 51.9%. The pooled proportion of recurrence after delayed thyroid surgery was 1.1%. These findings support the safety of active surveillance as an alternative to surgery for the management of low-risk papillary thyroid carcinoma, without raised risk of recurrence or death. Via this strategy, exposure to surgical risk and subsequent thyroid replacement therapy could be avoided.