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

doi:10.1507/endocrj.ej15-0634

Cited by 2 publications

(3 citation statements)

References 26 publications

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“…At first, the earlier approach to neoplastic diseases would appear associated with better case evolution. However, as already reported by other authors (15), early DTC diagnosis by FNAB, although reducing the time between nodule detection and thyroidectomy, does not interfere in patient evolution. In fact, in the present study, patients considered NDF at the last assessment were operated on earlier than those considered to be DF.…”

Section: Resultssupporting

confidence: 72%

“…In this context, some authors have reported that preoperative cytological diagnosis could be one more factor in DTC prognosis (8)(9)(10)(11)(12)(13). However, despite the relevance of Bethesda classification in thyroid neoplasia diagnosis, its prognostic role is still controversial (14,15). Some of the factors responsible for this lack of consensus could be the lack of adherence to cytological classification standardization, which still persists, and a lack of uniformity in outcome assessment.…”

Section: Introductionmentioning

confidence: 99%

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Is there a relationship between preoperative cytological diagnosis and evolution in patients with differentiated thyroid carcinoma? A retrospective study

Colenci¹,

Minicucci²,

Soares³

et al. 2022

Archives of Endocrinology and Metabolism

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Objective: Cytological analysis and Bethesda classification of thyroid nodules is the standard method of diagnosing differentiated thyroid carcinoma (DTC). However, even for nodules with a non-malignant cytological diagnosis, there is a not insignificant risk of cancer. There are doubts whether this lack of certainty would influence patient prognosis. Our aim was to compare patients with DTC, classified according to the preoperative cytological diagnosis, regarding their evolution. Subjects and methods: A retrospective study was carried out with 108 DTC patients submitted to total thyroidectomy (TT) between 2009 and 2015, divided into three groups according to preoperative cytological diagnosis (Bethesda classification): classes I/II, III/IV, and V/VI. Groups were compared for evolution considering response to treatment at last evaluation as well as time disease free. Statistical analysis used ANOVA, chi squared, and Kaplan-Meier curves with p<0.05 considered significant. Results: Groups differed for time between nodule puncture and TT [in months; V/VI (2.35 ± 2.48) < III/IV (7.32 ± 6.34) < I/II (13.36 ± 8.9); p < 0.0001]. There was no significant difference between groups for evolution at final evaluation (disease free status; classes I/II: 71.4%; classes III/IV: 60%; classes V/VI: 66.6%; p = 0.7433), as well as time disease free (in months; classes I/II: 34.57 ± 25.82; classes III/IV: 38.04 ± 26.66; classes V/VI: 30.84 ± 26.34; p = 0.3841). Conclusions: DTC patients classified according to preoperative cytological diagnosis did not differ for evolution. Although patients with non-malignant cytological diagnoses were submitted to TT later, this did not affect the evolution of the cases.

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Section: Resultssupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Is there a relationship between preoperative cytological diagnosis and evolution in patients with differentiated thyroid carcinoma? A retrospective study

Colenci¹,

Minicucci²,

Soares³

et al. 2022

Archives of Endocrinology and Metabolism

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“…It is a major challenge for clinicians, pathologists and radiologists how to screen the thyroid nodules e ciently. However, any single procedure looks like insu ciently to cover all kind of thyroid nodules [38,39] . Therefore, it is necessary to evaluate the reliable screening procedures.…”

Section: Discussionmentioning

confidence: 99%

Elastography reduces over-medical procedures in thyroid nodules: a systematic review and meta-analysis

Ke¹,

Cheng²,

Jian-cang³

et al. 2020

Preprint

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Background To evaluate the diagnostic performance of elastography in the differentiating the malignancy from thyroid nodule. Methods The literature published in English or Chinese prior to December 2019 which diagnosed by elastography in thyroid nodules were reviewed and summarized. According the inclusion and exclusion criteria, the elegant theses were reserved. Quality of each study was evaluated by the qu ality a ssessment of d iagnostic a ccuracy s tudies tool (QUADAS). Comprehensive Meta-Analysis Version 2.0 was used to describe primary results and explore homogeneity. Publication bias analysis was evaluated by Review Manager 5.3. Meta-Disc version 1.4 was applied to explore threshold effect, and pool sensitivity and specificity. A Summary ROC curve was constructed to calculate the area under the curve. Results As the heterogeneity was mild, we performance on random effect model. The publication bias was negligible. The elastography showed high accuracy in the diagnosis of malignant. The pooled sensitivity and specificity with corresponding 95% confidence interval were 0.80 (0.78, 0.82) and 0.80 (0.79, 0.81) respectively. AUC of sROC was 0.9087. Sensitivity analysis demonstrated that the pooled estimates were stable and reliable. Conclusions The elastography has obvious sensitivity and specificity in differentiate malignant from the thyroid nodule. Several different types of elastography could achieve the same aim, but the cut-off value is associate with the purpose of the screen program and the subtypes of the technique.

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Early diagnosis by FNA cytology should not influence the outcome of differentiated thyroid cancer

Cited by 2 publications

References 26 publications

Is there a relationship between preoperative cytological diagnosis and evolution in patients with differentiated thyroid carcinoma? A retrospective study

Is there a relationship between preoperative cytological diagnosis and evolution in patients with differentiated thyroid carcinoma? A retrospective study

Elastography reduces over-medical procedures in thyroid nodules: a systematic review and meta-analysis

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