TY - JOUR
T1 - Prognosis of patients with differentiated thyroid carcinomas having a preoperative cytological report of indeterminate at low or high risk. A multicenter study
AU - Trimboli, Pierpaolo
AU - Palermo, Andrea
AU - Deandrea, Maurilio
AU - Piccardo, Arnoldo
AU - Campennì, Alfredo
AU - Valabrega, Stefano
AU - Grani, Giorgio
AU - Santolamazza, Giuliano
AU - Bottoni, Gianluca
AU - Barnabei, Agnese
AU - Ramundo, Valeria
AU - Lauretta, Rosa
AU - Monte, Lavinia
AU - Ferrarazzo, Giulia
AU - Paone, Gaetano
AU - Crosetto, Cecilia
AU - Ruggeri, Rosaria Maddalena
AU - Baldari, Sergio
AU - Chiefari, Alfonsina
AU - Vottari, Sebastiano
AU - Giarnieri, Enrico
AU - Perrella, Eleonora
AU - Limone, Paolo
AU - Durante, Cosimo
AU - Giovanella, Luca
AU - Appetecchia, Marialuisa
AU - Crescenzi, Anna
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Background: Italian cytology system for thyroid fine-needle aspiration (FNA) includes indeterminate lesions at low- (Tir 3A) and high-risk (Tir 3B). The present retrospective multicenter study was undertaken to compare the histological type of cancers and disease-free survival in these two groups. Methods: Eight institutions participated. Thyroid cancer patients diagnosed and followed-up after Tir 3A or Tir 3B were reviewed. Histological diagnosis was adopted as the gold standard. Patients were defined with cancer recurrence or no evidence of disease. Disease-free survival (DFS) was calculated. A non-parametric statistical analysis was used. DFS was estimated by Kaplan–Meier method and Hazard Ratio (HR) defined the slope of curves. Results: Two hundred and nine patients (median DFS 24 months) were enrolled and a 6.3% of these recurred. Tir 3B group had higher age (p = 0.014), larger cancer size (p = 0.0002), shorter DFS (p = 0.003), higher number of aggressive cancers (p = 0.006), and relapse frequency double than Tir 3A. At survival curves analysis, Tir 3B group had HR of 2.37 with respect to Tir 3A. At Cox’s proportional hazard regression analysis histology was the only significant predictor of relapse. Conclusions: While patients with thyroid FNA of Tir 3B should be addressed to surgery due to high likelihood of more aggressive cancer, a diagnostic surgery could be avoided in patients with Tir 3A if concurrent unsuspicious clinical features are found.
AB - Background: Italian cytology system for thyroid fine-needle aspiration (FNA) includes indeterminate lesions at low- (Tir 3A) and high-risk (Tir 3B). The present retrospective multicenter study was undertaken to compare the histological type of cancers and disease-free survival in these two groups. Methods: Eight institutions participated. Thyroid cancer patients diagnosed and followed-up after Tir 3A or Tir 3B were reviewed. Histological diagnosis was adopted as the gold standard. Patients were defined with cancer recurrence or no evidence of disease. Disease-free survival (DFS) was calculated. A non-parametric statistical analysis was used. DFS was estimated by Kaplan–Meier method and Hazard Ratio (HR) defined the slope of curves. Results: Two hundred and nine patients (median DFS 24 months) were enrolled and a 6.3% of these recurred. Tir 3B group had higher age (p = 0.014), larger cancer size (p = 0.0002), shorter DFS (p = 0.003), higher number of aggressive cancers (p = 0.006), and relapse frequency double than Tir 3A. At survival curves analysis, Tir 3B group had HR of 2.37 with respect to Tir 3A. At Cox’s proportional hazard regression analysis histology was the only significant predictor of relapse. Conclusions: While patients with thyroid FNA of Tir 3B should be addressed to surgery due to high likelihood of more aggressive cancer, a diagnostic surgery could be avoided in patients with Tir 3A if concurrent unsuspicious clinical features are found.
KW - Carcinoma
KW - Fine-needle aspiration (FNA)
KW - Follow-up
KW - Indeterminate nodules
KW - Thyroid
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U2 - 10.1007/s12020-019-02013-9
DO - 10.1007/s12020-019-02013-9
M3 - Article
C2 - 31313225
AN - SCOPUS:85069210833
VL - 66
SP - 557
EP - 562
JO - Endocrine
JF - Endocrine
SN - 1355-008X
IS - 3
ER -