Is Malignant Nodule Topography an Additional Risk Factor for Metastatic Disease in Low-Risk Differentiated Thyroid Cancer?

Campennì, Alfredo; Giovanella, Luca; Siracusa, Massimiliano; Stipo, Maria Elena; Alibrandi, Angela; Cucinotta, Mariapaola; Ruggeri, Rosaria M.; Baldari, Sergio

doi:10.1089/thy.2014.0217

Cited by 36 publications

(28 citation statements)

References 19 publications

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“…We recently published that the prevalence of lymph-node metastases was significantly higher in patients with low-risk DTC located in the isthmus compared to those located in thyroid lobes. 1 We concluded that the isthmic localization of the malignant thyroid nodule was an independent risk factor in patients with low-risk DTC. In our series of papillary thyroid carcinoma (PTC), patients with isthmus lesion had undergone TRA by 131radioiodine ablative activity (range 1110-3700 MBq; median 2753 MBq) oral administration and their median follow-up was 5 years (range 2-7 years).…”

Section: Braf (V600e) Mutation In Isthmic Malignant Thyroid Nodulesmentioning

confidence: 75%

“…In our series of papillary thyroid carcinoma (PTC), patients with isthmus lesion had undergone TRA by 131radioiodine ablative activity (range 1110-3700 MBq; median 2753 MBq) oral administration and their median follow-up was 5 years (range 2-7 years). 1 All except one patients reached an 'excellent response' status [i.e. undetectable basal and stimulated thyroglobulin (Tg) serum levels (<1 ng/ml); negative neck ultrasound] 3 with the first 131-radioiodine ablative therapy, as appreciated during the first follow-up performed 12 months after TRA.…”

Section: Braf (V600e) Mutation In Isthmic Malignant Thyroid Nodulesmentioning

confidence: 99%

“…However, the prevalence of lymphnode metastases in patients affected by low-risk cancer is not negligible, ranging from 10 to 30%. 1,2 Thus, the choice to perform or to rule out TRA is based on risk factors such as age, gender, histological variants.…”

Section: Braf (V600e) Mutation In Isthmic Malignant Thyroid Nodulesmentioning

confidence: 99%

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BRAF (V600E) mutation in isthmic malignant thyroid nodules

Campennì

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Alibrandi

et al. 2015

Clinical Endocrinology

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Section: Braf (V600e) Mutation In Isthmic Malignant Thyroid Nodulesmentioning

confidence: 75%

Section: Braf (V600e) Mutation In Isthmic Malignant Thyroid Nodulesmentioning

confidence: 99%

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BRAF (V600E) mutation in isthmic malignant thyroid nodules

Campennì

Giovanella

Alibrandi

et al. 2015

Clinical Endocrinology

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“…However, thyroid cancers are rare, accounting for about 2–5% of all thyroid nodules 2–4 . Diagnostic evaluation of thyroid nodules includes laboratory tests and thyroid ultrasonography (US).…”

Section: Introductionmentioning

confidence: 99%

Differentiating malignant from benign thyroid nodules with indeterminate cytology by 99mTc-MIBI scan: a new quantitative method for improving diagnostic accuracy

Campennì

Siracusa

Ruggeri

et al. 2017

Sci Rep

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Quantitative 99mTc-MIBI thyroid scintigraphy is a useful tool in differentiating malignant from benign thyroid nodules with indeterminate cytology. The aim of our report is to compare the diagnostic performance of different quantitative methods. We prospectively evaluated 20 patients affected by a thyroid nodule with a cytological diagnosis of class III or IV according to the Bethesda system. Planar images of the thyroid were acquired 10 and 60 minutes after 99mTc-MIBI administration and two different quantitative methods applied (i.e. wash-out index, WOind; retention index, R.I.). All patients underwent lobectomy or thyroidectomy and final histological findings were matched with MIBI results obtained with both quantitative methods. Four out of 20 patients had a final histological result of differentiated thyroid cancer, while benign findings were found in the remaining cases. Overall sensitivity, specificity, accuracy, PPV and NPV were 100% in all for the WOind and 100%, 57.1%, 62.5%, 25% for the R.I., respectively. In conclusion 99mTc-semiquantitative MIBI thyroid scintigraphy with WOind calculation is highly accurate in differential diagnosis of nodules with indeterminate cytology reading.

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“…Consequently, the "minimal extrathyroid spread" in thyroid carcinoma represents the basis of a systematic scientific analysis of biological relevance, including at the same time the tumor size given as pT category (Table 1) (17,26,32). Furthermore, an analysis of tumor localization as prognostic factor is attractive in the near future (33); on this way, the location of thyroid cancer in the isthmus may be considered as an additional risk factor for radioactive iodine (RAI) avid metastatic disease in pT1a-pT1b DTC patients, regardless of the presence or absence of other risk factors (33).…”

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confidence: 99%

Pitfalls in the 2017 TNM Classification of Thyroid Carcinoma

et al. 2018

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The objective of this article is to detail the 2017 tumor-node-metastasis (TNM) staging criteria for thyroid cancer. The literature presents only few contributions, with controversial results, about comparison between previous and the new TNM systems. The 2017 TNM classification categorizes either thyroid carcinomas only limited to the gland either carcinomas macroscopically infiltrating into defined anatomical structures. The "minimal extrathyroid spread" into the perithyroidal adipose tissue no longer appears as a classification parameter in the new TNM. In the present paper is discussed for the pT categories pT1a, pT1b, pT2, and pT3a. In detail, the T-categories pT1a, pT1b, pT2, and pT3a are each subdivided into true thyroid-restricted carcinomas (pT1a1, pT1b1, pT2a1, and pT3a1) and "minimal extrathyroid proliferation" carcinomas (pT1a2, pT1b2, pT2b, and pT3a2). As a basis, a strict definition of the "minimal extrathyroid propagation" of thyroid carcinomas is essential. Although the suggestion made with the additional substrate characterization makes the work of the pathologist more intricate in daily use, standardized fundamentals for demonstrating or excluding the prognostic and therapeutic relevance concerning a "minimal extrathyroid extension" in thyroid carcinoma appear to be necessary. PREFACEMany efforts have been made to reach a higher accuracy in the tumor staging classifications (1). Tumor staging classifications demand to be constantly updated to latest clinical, anatomic, numeric criterion, pathological, molecular biology, genetics and biochemical findings in order to fulfill their function of internationally accepted standardization and comparability of objective pathological data as the basis for managing patients with malignant diseases (1).Specific standards have to be considered for the determination of the anatomical spread of malignant tumors by the clinical tumor-node-metastasis (cTNM) and pathological tumor-node-J Endocr Surg. 2018 Jun;18(2):98-109 https://doi.

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Is Malignant Nodule Topography an Additional Risk Factor for Metastatic Disease in Low-Risk Differentiated Thyroid Cancer?

Abstract: Our data show for the first time that a location of a thyroid cancer in the isthmus is an additional risk factor for RAI avid metastatic disease in pT1a-pT1b DTC patients, regardless of the presence or absence of other risk factors.

Cited by 36 publications

References 19 publications

BRAF (V600E) mutation in isthmic malignant thyroid nodules

BRAF (V600E) mutation in isthmic malignant thyroid nodules

Differentiating malignant from benign thyroid nodules with indeterminate cytology by 99mTc-MIBI scan: a new quantitative method for improving diagnostic accuracy

Pitfalls in the 2017 TNM Classification of Thyroid Carcinoma

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