Prevalence of Contralateral Tumors in Patients with Follicular Variant of Papillary Thyroid Cancer

Sullivan, Michael C.; Graham, Paul H.; Alexander, Erik K.; Ruan, Daniel T.; Nehs, Matthew A.; Gawande, Atul A.; Moore, Francis D.; Howitt, Brooke E.; Strickland, Kyle C.; Krane, Jeffrey F.; Barletta, Justine A.; Cho, Nancy L.

doi:10.1016/j.jamcollsurg.2016.12.007

Cited by 12 publications

(5 citation statements)

References 36 publications

(36 reference statements)

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“…In the management of thyroid cancer, points in favour of TT are: treatment of multicentric and bilateral tumors (as an hallmark of papillary carcinoma), improved disease-free survival, less local recurrence which are associated to reoperative complications and decreased survival, improved detection and elimination by radioiodine treatment of persistent and metastatic disease, improved surveillance by thyroglobulin dosage, contained primary surgical complications in high volume centres not differing from those observed after L and of course elimination of the risk of completion surgery. As in our experience the high incidence of contralateral tumors associated to a follicular variant of papillary carcinoma, similarly described by Sullivan et al in the 35% of their cases [20], supports the rationale of performing radical surgery in order to reduce the misdiagnosis and either the need for further surgeries. As opposite arguments, L might be preferred since occult residual cancer foci are usual non-progressive and without implication on morbidity and survival [16].…”

Section: Discussionsupporting

confidence: 85%

Follicular proliferation TIR3B: the role of total thyroidectomy vs lobectomy

et al. 2019

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Background: TIR3B thyroid nodules are considered to be at risk of malignancy (15-30%) but guidelines recommend conservative surgery with lobectomy with primary diagnostic porpoise. Risk stratification mainly based on ultrasound, elastography and genetic mutations usually may influences the surgical approach. Methods: We retrospectively analyzed 52 cases of TIR3B underwent between 2015 and 2017 total thyroidectomy (TT) and lobectomy (L), focusing mainly on the observed rate of malignancy. Chi-squared test and Fisher's exact probability test were used for analysis, considering a P values less than 0.05 as significant. Results: Out of 52 patients 49 underwent TT and 3 L. In TT group a multinodular goiter was associated in 67.3% of patients. Malignancy rate was 81.6 and 33.3% respectively after TT and L (P 0.003). Multicentric and contralateral tumors were detected respectively in 36.7% and in 32.6% of patients underwent TT. No main post-operative complications were registered. Conclusions: Ultrasound and elastography are useful to define within the TIR3B group those lesions at higher risk and therefore requiring a more radical approach. TT seems an appropriate approach to TIR3B lesions, especially in multinodular goiter, considering the incidence of malignancy with probably higher rate than previously reported.

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Section: Discussionsupporting

confidence: 85%

Follicular proliferation TIR3B: the role of total thyroidectomy vs lobectomy

et al. 2019

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“…According to the 2015 American Thyroid Association (ATA) guidelines, contralateral thyroid nodules may be a criterion for a bilateral procedure because of plans for radioiodine (RAI) therapy or to facilitate followup strategies or address suspicions of bilateral disease (Recommendation 35) (11). Several studies have shown the risk for contralateral papillary thyroid carcinoma (PTC) is high, with reporting rates up to 44% (12)(13)(14)(15)(16)(17)(18)(19). However, these numbers do not take into consideration the sonographic features of the contralateral lobe by which these lesions can be detected and evaluated (17).…”

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confidence: 99%

Natural History of Contralateral Nodules After Lobectomy in Patients With Papillary Thyroid Carcinoma

Ritter

Bachar

Hirsch

et al. 2017

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…Several studies have shown a high incidence of contralateral occult PTC, up to more than 40% (17,18). However, these studies did not take into consideration the adverse clinicopathological characteristics of proven unilateral PTC, such as multifocality, large tumor size and extrathyroidal extension, and the US features of the contralateral nodules, which may guide careful detection and evaluation of occult disease.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of nonsuspicious contralateral nodules with active surveillance after lobectomy in patients with papillary thyroid carcinoma

Huang

Liu²,

Wang³

et al. 2022

Front. Endocrinol.

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ObjectiveTo observe the outcomes of nonsuspicious contralateral nodules with active surveillance in patients with papillary thyroid carcinoma (PTC).Methods4pt?>Consecutive patients who underwent lobectomy for PTC were retrospectively reviewed. Patients with one or more nodules with nonsuspicious ultrasonography (US) features in the contralateral lobe were included.ResultsTwo hundred and eighty-three patients were included. All patients underwent thyroid lobectomy with ipsilateral prophylactic central neck dissection. A total of 123 patients (43.5%) were classified as ATA low-risk, and 160 patients (56.5%) were classified as intermediate-risk. The median size of the contralateral nodules was 3 mm (range, 2 to 16 mm). After a period of follow-up, the median size change of contralateral nodules was 0 mm (range, -7 to 8 mm). Eight patients (2.8%) had nodule growth >3 mm, 223 patients (78.8%) had stable or decreased nodules, and 52 patients (18.4%) had no detectable nodules. Nodules in 24 patients had suspicious US features, 16 of which were diagnosed with PTMC by either cytology after FNA (in 7 patients) or histopathology after completion thyroidectomy (in 9 patients). Another four patients received completion thyroidectomy for ipsilateral cervical lymph node metastasis. The 5-year residual lobe recurrence (RLR) rate and recurrence-free survival (RFS) rate were 7.4% and 89.8%, respectively. Multivariate analysis showed that multifocality and ATA intermediate-risk were independent predictors for RLR (HR4.083, 95%CI 1.480-11.261, P = 0.007; HR 6.045, 95%CI 1.370-26.662, P = 0.017, respectively) and RFS (HR 5.240, 95%CI 2.114-12.991, P < 0.001; HR 5.223, 95%CI 1.353-17.765, P = 0.008, respectively).ConclusionsActive surveillance for nonsuspicious contralateral nodules in patients with low-risk and selected intermediate-risk PTC is safe. Multifocality and ATA intermediate-risk are predicters for recurrence. Early detection and salvage surgery are effective.

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Prevalence of Contralateral Tumors in Patients with Follicular Variant of Papillary Thyroid Cancer

Cited by 12 publications

References 36 publications

Follicular proliferation TIR3B: the role of total thyroidectomy vs lobectomy

Follicular proliferation TIR3B: the role of total thyroidectomy vs lobectomy

Natural History of Contralateral Nodules After Lobectomy in Patients With Papillary Thyroid Carcinoma

Outcomes of nonsuspicious contralateral nodules with active surveillance after lobectomy in patients with papillary thyroid carcinoma

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