Inter-Observer Variation in the Pathologic Identification of Minimal Extrathyroidal Extension in Papillary Thyroid Carcinoma

Su, Henry; Wenig, Bruce M.; Haser, Grace C.; Rowe, Meghan E.; Sylvia, L.; Baloch, Zubair W.; Du, Eugenie; Faquin, William C.; Fellegara, Giovanni; Giordano, Thomas J.; Ghossein, Ronald; LiVolsi, Virginia A.; Lloyd, Ricardo V.; Mete, Özgür; Özbek, Umut; Rosaí, Juan; Suster, Saul; Thompson, Lester D.�R.; Turk, Andrew T.; Urken, Mark L.

doi:10.1089/thy.2015.0508

Cited by 58 publications

(28 citation statements)

References 16 publications

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“…This is most likely explained by the fact that patients who harboured PTC with minimal extrathyroidal extension and who were explicitly categorized in previous editions as having T3 tumours are no longer identified as such in the eighth edition. However, overall agreement on the identification and pathological reporting of minimal extrathyroidal extension is poor, and there are conflicting results from other studies on the prognostic relevance of minimal extrathyroidal extension. Analysis of data concerning the potential relevance of minimal extrathyroidal extension to patient outcomes should continue.…”

Section: Discussionmentioning

confidence: 94%

Predicting recurrence of papillary thyroid cancer using the eighth edition of the AJCC/UICC staging system

Chéreau

Oyekunle

Zambeli-Ljepovic

et al. 2019

British Journal of Surgery

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Background: The AJCC/UICC classification is widely used for predicting survival in papillary thyroid cancer (PTC), but has not been evaluated as a predictor of recurrence. The hypothesis of this study was that the eighth edition of the AJCC system can be used in this novel way. Methods: All patients in the study underwent surgery for PTC at a high-volume endocrine surgery centre in France between 1985 and 2015. The seventh and eighth editions of the AJCC/UICC staging system for PTC were employed to predict recurrence and disease-specific survival using the Kaplan–Meier and log rank tests. Results: Among 4124 patients (79.7 per cent female), median age was 50 (i.q.r. 38–60) years; 3906 patients (94.7 per cent) underwent total thyroidectomy, with lymph node dissection in 2495 (60.5 per cent). The eighth edition placed 91.8, 7.1, 0.4 and 0.7 per cent of patients in stages I–IV respectively. After reclassifying patients from the seventh to the eighth AJCC/UICC edition, the disease was downstaged in 23.8 per cent. Over a median follow-up of 7 years, 260 patients (6.4 per cent) developed recurrent disease, including 5.2 per cent of patients with stage I, 19.6 per cent with stage II, 59 per cent with stage III and 50 per cent with stage IV disease, according to the eighth edition. The eighth edition was a better predictor of recurrence than the seventh edition. Conclusion: The eighth edition of the AJCC/UICC staging system appears to be a novel tool for predicting PTC recurrence, which is a meaningful outcome for this indolent disease. The eighth edition can be used to risk-stratify patients, keeping in mind that other molecular and pathological predictive factors must be integrated into the assessment of recurrence risk.

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Section: Discussionmentioning

confidence: 94%

Predicting recurrence of papillary thyroid cancer using the eighth edition of the AJCC/UICC staging system

Chéreau

Oyekunle

Zambeli-Ljepovic

et al. 2019

British Journal of Surgery

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“…While there is still considerable interobserver variability about the detection of extrathyroidal extension [55], it seems that most pathologists use histologic features of tumor involving fat, skeletal muscle, nerve, and thickwalled vessels as major criteria to represent microscopic extrathyroidal extension [55], and thus similar criteria were employed here. In the present series, the majority of cases were staged group I (68 %) with the remainder, when using soft tissue extension criteria, group III (32 %).…”

Section: Discussionmentioning

confidence: 99%

Thyroglossal Duct Cyst Carcinomas: A Clinicopathologic Series of 22 Cases with Staging Recommendations

Thompson

Herrera

Lau³

2016

Head and Neck Pathol

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Carcinomas arising from thyroglossal duct remnant cysts (TGDCs) are rare, without well-defined management and staging criteria. All TGDCs (n = 685) diagnosed between 2005 and 2015 were retrospectively reviewed, with 22 carcinomas identified (3.2 % incidence). Twenty-two patients (17 females, 5 males), aged 12-64 years (mean 39.9 years; median 39 years) were identified. An anterior, superior midline neck mass was the presenting symptom in all patients. A cancer diagnosis [all papillary thyroid carcinoma (PTC)] was made after the Sistrunk procedure (SP), with a Bethesda Category V or VI classification preoperatively by fine needle aspiration in 5 of 12 cases tested. A SP was performed in all patients, with total thyroidectomy concurrently (n = 4) or subsequently (n = 12). A selected neck dissection was performed in 5 patients, with metastases found in 3. Of the patients who had a thyroidectomy, syn-

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“…It is important to emphasize that micro‐PTCs in this study were not incidental “occult” tumors just because they were detected by ultrasound in asymptomatic patients. The high rates of extrathyroidal extension to the fat and connective tissue and nodal disease attest to the justified treatment tactics that included surgery in view of the patients’ young age and the risk of rapid progression of tumors with such invasive characteristics …”

Section: Discussionmentioning

confidence: 92%

“…The high rates of extrathyroidal extension to the fat and connective tissue and nodal disease attest to the justified treatment tactics that included surgery in view of the patients' young age and the risk of rapid progression of tumors with such invasive characteristics. [30][31][32][33] It should be noted that in 2017, the criteria for ascribing welldifferentiated thyroid carcinomas pT3 category were revised in the 8th edition of the TNM classification. 34 According to this classification, tumors larger than 40 mm confined to the thyroid belong to the PTCs would migrate from the pT3 to pT1a, pT1b, and pT2 categories.…”

Section: Discussionmentioning

confidence: 99%

Histopathological analysis of papillary thyroid carcinoma detected during ultrasound screening examinations in Fukushima

et al. 2019

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Thyroid ultrasound screening of young residents in Fukushima Prefecture, Japan, showed a high detection rate of papillary thyroid carcinoma (PTC). Detailed morphological analysis of these tumors was not presented to date. This study sets out to evaluate changes in histopathological and invasive characteristics of Fukushima PTC with time after the nuclear accident of March 2011 in all available cases and in different age subgroups. Histological specimens of 115 PTCs from patients aged 18 years or younger at the time of the Fukushima Dai‐ichi Nuclear Power Plant accident, who underwent surgical resection at Fukushima Medical University during 2012‐2016, were reviewed. Patients were divided into those treated during the first 4 years after the accident (n = 78, shorter‐onset) or later (n = 37, longer‐onset). The whole group and 3 age subgroups: children (aged less than 15 years), adolescents (aged from 15 to less than 19 years), and young adults (aged from 19 years) at surgery were analyzed. No statistically significant time‐related changes in tumor structure or invasiveness were found in the whole group or in age‐matched subgroups. Statistically significant age‐related downtrend was observed for intrathyroid spread in the whole group of patients. The absence of temporal changes in tumor morphological characteristics and tumor invasiveness strongly suggests common etiology of the shorter‐ and longer‐onset Fukushima PTCs, which are unlikely related to the effect of exposure to very low doses of radiation.

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Inter-Observer Variation in the Pathologic Identification of Minimal Extrathyroidal Extension in Papillary Thyroid Carcinoma

Cited by 58 publications

References 16 publications

Predicting recurrence of papillary thyroid cancer using the eighth edition of the AJCC/UICC staging system

Predicting recurrence of papillary thyroid cancer using the eighth edition of the AJCC/UICC staging system

Thyroglossal Duct Cyst Carcinomas: A Clinicopathologic Series of 22 Cases with Staging Recommendations

Histopathological analysis of papillary thyroid carcinoma detected during ultrasound screening examinations in Fukushima

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