Intraoperative Pathologic Examination: Cost Effectiveness and Clinical Value in Patients with Cytologic Diagnosis of Cellular Follicular Thyroid Lesion

Miller, Matthew C.; Rubin, Cory J.; Cunnane, Mary F.; Bibbo, Marluce; Miller, Jeffrey L.; Keane, William M.; Pribitkin, Edmund A.

doi:10.1089/thy.2006.0166

Cited by 36 publications

(25 citation statements)

References 53 publications

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“…In addition, completion thyroidectomy requires working in a recently operated field with scarring and partial obliteration of tissue planes. The patient must also undergo general anesthesia and endure postoperative pain and recovery for a second operation [11].…”

Section: Discussionmentioning

confidence: 99%

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Intraoperative Frozen Biopsy of Central Lymph Node in the Management of Papillary Thyroid Microcarcinoma

Lee

Yoon

Kim

et al. 2015

Indian J Otolaryngol Head Neck Surg

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The purpose of this study was to evaluate the usefulness and accuracy of intraoperative frozen section examination in the diagnosis of metastatic central lymph nodes in comparison to the final histopathological findings. A retrospective review was performed to evaluate patients with a preoperative diagnosis of papillary thyroid microcarcinoma (PTMC) and a plan to perform thyroid lobectomy at our Hospital from September 2011 to September 2013. Sixteen patients were identified. Intraoperative frozen section examination diagnosed ten patients as negative malignant cells of the central lymph node and the remaining six patients as metastatic central lymph node. The final histopathological results corresponded with intraoperative frozen section examination. Intraoperative frozen section examination had a sensitivity, specificity and accuracy of 100 % for diagnosing metastatic central lymph nodes of PTMC. Intraoperative frozen section examination of central lymph nodes is a useful and accurate adjunct for determining the operation method in PTMC.

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Section: Discussionmentioning

confidence: 99%

“…A risk arises from a false positive result and the subsequent performance of an unnecessary total thyroidectomy. Despite this, frozen section examination of thyroid lesions remains a highly accurate procedure with a low false positive rate, and it should not be used as an argument against its routine use [11][12][13].…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Frozen Biopsy of Central Lymph Node in the Management of Papillary Thyroid Microcarcinoma

Lee

Yoon

Kim

et al. 2015

Indian J Otolaryngol Head Neck Surg

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“…In order to eliminate the need of complementary thyroidectomy with a second surgery, diagnostic lobectomy is frequently performed along with intraoperative frozen section examination in patients with uncertain FNAB results. Intraoperative frozen section analysis was reported to decrease the number of complementary thyroidectomies and to reduce the cost when used, especially in follicular neoplasms (20). Cheng et al (21) reported that frozen section examination was useful in patients having suspected FNAB results or follicular lesions, especially in making the diagnosis of papillary cancer and making the decision of total thyroidectomy in one stage.…”

Section: Frozen Section Examinationmentioning

confidence: 99%

The Management of Thyroid Nodules

Ulusoy¹

2016

Turk Arch Otorhinolaryngol

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ReviewThyroid nodules are extremely common and are detected in 3%-7% of the general population by palpation and in 70% of the population by ultrasonography (USG). Approximately 5%-15% of these nodules are malignant. Therefore, in nodule examination, our primary aim is to detect malignant nodules. Besides the medical history and the findings of the physical examination, USG and fine-needle aspiration biopsy (FNAB) are the most commonly used methods to examine these nodules. Ultrasound-guided FNAB and on-site assessment of FNA specimens are suggested to decrease false negative and non-diagnostic test results. FNAB results in the "atypia of undetermined significance" group is challenging in the follow-up or treatment of the nodule. In this group, to differentiate the malignant nodules, other developing methods, such as analyzing molecular genetic markers, protein markers, and elastography, are generally studied. However, these methods are not used in a routine nodule examination because of cost-benefit analysis. Keywords

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“…Incidence of frozen sections on thyroid glands Several recent studies have reported a decrease in the number of frozen section diagnosis for thyroid lesions [3][4][5]9]. To some degree, the number and type of thyroid frozen sections are likely to depend on the experience of the surgical team, the case volume, and on the prevalent types of surgeries being performed.…”

Section: Thyroid Frozen Sectionsmentioning

confidence: 99%

“…Frozen section examinations in endocrine pathology have been most commonly used for intraoperative assessment of thyroid and parathyroid tumors and cervical lymph node metastases. In recent years, however, the number of frozen sections in thyroid surgery has been steadily decreasing worldwide [3][4][5]. This decline has been attributed to two major factors: the high diagnostic accuracy of fine needle aspiration (FNA) cytology for papillary thyroid carcinoma (PTC) and the low sensitivity of frozen section diagnosis for follicular lesions of the thyroid.…”

Section: Introductionmentioning

confidence: 99%

Current practices in performing frozen sections for thyroid and parathyroid pathology

Osamura

Hunt

2008

Virchows Arch

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In this review article, current trends in thyroid and parathyroid frozen sections are discussed. In Japan and other countries, the numbers of thyroid frozen sections have been dramatically decreasing over the past decade. The decline in the number of thyroid frozen sections has been attributed to two major factors: highly diagnostic preoperative fine needle aspiration for papillary carcinomas, the most frequent type of thyroid cancers, and the acknowledgment in the literature of the disadvantageous frozen sections for follicular tumors. Several authors have argued that the frozen section of thyroid nodules should be limited only to cases that have a preoperative cytology diagnosis as "atypical" or "suspicious". In contrast, frozen sections for parathyroid glands have been increasing in numbers. This increase is thought to be largely due to the high number of parathyroidectomies for secondary hyperplasia in dialysis patients. Frozen sections are usually performed to confirm the removal of parathyroid tissue for either cyropreservation or auto-transplantation. It is concluded that thyroid and parathyroid frozen section examination is restricted to selected situations.

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Intraoperative Pathologic Examination: Cost Effectiveness and Clinical Value in Patients with Cytologic Diagnosis of Cellular Follicular Thyroid Lesion

Abstract: IOPE reduced costs and limited the number of completion thyroidectomies necessary. IOPE is specific, cost effective, and of minimal additional risk when performed routinely for patients with CFL or FN.

Cited by 36 publications

References 53 publications

Intraoperative Frozen Biopsy of Central Lymph Node in the Management of Papillary Thyroid Microcarcinoma

Intraoperative Frozen Biopsy of Central Lymph Node in the Management of Papillary Thyroid Microcarcinoma

The Management of Thyroid Nodules

Current practices in performing frozen sections for thyroid and parathyroid pathology

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