Abstract
In oncology, the early cancer detection is recognized as associated with good patient’s prognosis. Then, one could expect that differentiated thyroid carcinoma (DTC) undergone fine-needle aspiration cytology (FNA) early have better outcome. Aim of this study was to investigate if DTC prognosis is improved by early FNA diagnosis. DTCs followed-up at our institution were included. Information about initial management of thyroid lesion, FNA, surgery, and postoperative follow-up was collected. Cytologies were classified according to British Thyroid Association (BTA). The final series comprised 219 DTCs, of which 22 (10%) recurred. The length of time between nodule appearance and cancer treatment was significantly (p<0.0001) shorter in patients who had undergone FNA than those who had not. In the FNA group, 73 patients underwent biopsy within six months, 25 at 7-12 months, and 43 after at least one year. Regardless of this highly significant (p<0.0001) difference, the results of TNM staging and cancer recurrence rate were no different between these three subgroups. This result was confirmed in DTCs larger than 1 cm submitted to FNA within 12 months or later. When we evaluated the impact of nodule’s presentation on DTC outcome, clinically discovered cancers were significantly associated with relapse (OR 2.81) and advanced TNM stages (p=0.03). These data show a lack of clinical impact of the delayed diagnosis of DTC. Also, the postoperative outcome of these patients should not be influenced by the timing of FNA. Instead, DTC patients with preoperative clinical nodule appearance should be considered at higher risk of relapse.
| Original language | English |
|---|---|
| Pages (from-to) | 367-373 |
| Number of pages | 7 |
| Journal | Endocrine Journal |
| Volume | 63 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 25 2016 |
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Keywords
- Cytology
- FNA
- Prognosis
- Thyroid cancer
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
- Endocrinology
Cite this
Early diagnosis by FNA cytology should not influence the outcome of differentiated thyroid cancer. / Trimboli, Pierpaolo; Nigri, Giuseppe; Guidobaldi, Leo; Romanelli, Francesco; Aurello, Paolo; Crescenzi, Anna; Appetecchia, Marialuisa; Giovanella, Luca; Valabrega, Stefano.
In: Endocrine Journal, Vol. 63, No. 4, 25.04.2016, p. 367-373.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Early diagnosis by FNA cytology should not influence the outcome of differentiated thyroid cancer
AU - Trimboli, Pierpaolo
AU - Nigri, Giuseppe
AU - Guidobaldi, Leo
AU - Romanelli, Francesco
AU - Aurello, Paolo
AU - Crescenzi, Anna
AU - Appetecchia, Marialuisa
AU - Giovanella, Luca
AU - Valabrega, Stefano
PY - 2016/4/25
Y1 - 2016/4/25
N2 - In oncology, the early cancer detection is recognized as associated with good patient’s prognosis. Then, one could expect that differentiated thyroid carcinoma (DTC) undergone fine-needle aspiration cytology (FNA) early have better outcome. Aim of this study was to investigate if DTC prognosis is improved by early FNA diagnosis. DTCs followed-up at our institution were included. Information about initial management of thyroid lesion, FNA, surgery, and postoperative follow-up was collected. Cytologies were classified according to British Thyroid Association (BTA). The final series comprised 219 DTCs, of which 22 (10%) recurred. The length of time between nodule appearance and cancer treatment was significantly (p<0.0001) shorter in patients who had undergone FNA than those who had not. In the FNA group, 73 patients underwent biopsy within six months, 25 at 7-12 months, and 43 after at least one year. Regardless of this highly significant (p<0.0001) difference, the results of TNM staging and cancer recurrence rate were no different between these three subgroups. This result was confirmed in DTCs larger than 1 cm submitted to FNA within 12 months or later. When we evaluated the impact of nodule’s presentation on DTC outcome, clinically discovered cancers were significantly associated with relapse (OR 2.81) and advanced TNM stages (p=0.03). These data show a lack of clinical impact of the delayed diagnosis of DTC. Also, the postoperative outcome of these patients should not be influenced by the timing of FNA. Instead, DTC patients with preoperative clinical nodule appearance should be considered at higher risk of relapse.
AB - In oncology, the early cancer detection is recognized as associated with good patient’s prognosis. Then, one could expect that differentiated thyroid carcinoma (DTC) undergone fine-needle aspiration cytology (FNA) early have better outcome. Aim of this study was to investigate if DTC prognosis is improved by early FNA diagnosis. DTCs followed-up at our institution were included. Information about initial management of thyroid lesion, FNA, surgery, and postoperative follow-up was collected. Cytologies were classified according to British Thyroid Association (BTA). The final series comprised 219 DTCs, of which 22 (10%) recurred. The length of time between nodule appearance and cancer treatment was significantly (p<0.0001) shorter in patients who had undergone FNA than those who had not. In the FNA group, 73 patients underwent biopsy within six months, 25 at 7-12 months, and 43 after at least one year. Regardless of this highly significant (p<0.0001) difference, the results of TNM staging and cancer recurrence rate were no different between these three subgroups. This result was confirmed in DTCs larger than 1 cm submitted to FNA within 12 months or later. When we evaluated the impact of nodule’s presentation on DTC outcome, clinically discovered cancers were significantly associated with relapse (OR 2.81) and advanced TNM stages (p=0.03). These data show a lack of clinical impact of the delayed diagnosis of DTC. Also, the postoperative outcome of these patients should not be influenced by the timing of FNA. Instead, DTC patients with preoperative clinical nodule appearance should be considered at higher risk of relapse.
KW - Cytology
KW - FNA
KW - Prognosis
KW - Thyroid cancer
UR - http://www.scopus.com/inward/record.url?scp=84964252145&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84964252145&partnerID=8YFLogxK
U2 - 10.1507/endocrj.EJ15-0634
DO - 10.1507/endocrj.EJ15-0634
M3 - Article
VL - 63
SP - 367
EP - 373
JO - Endocrine Journal
JF - Endocrine Journal
SN - 0918-8959
IS - 4
ER -