Impact of the Italian Society of Anatomic Pathology and Diagnostic Cytology Classification of Thyroid Nodules in the Treatment of Indeterminate Follicular Lesions: Five-Year Results at a Single Center
Purpose. Aim of the study was to assess the impact of the Italian Society of Anatomic Pathology and Diagnostic Cytology (SIAPEC) classification of 2014, on the treatment of indeterminate thyroid lesions (TIR3). Methods. We retrospectively analyzed patients undergoing thyroid surgery for TIR3 lesions...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-01-01
|
| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2020/7325260 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849695444121157632 |
|---|---|
| author | M. Pastoricchio A. Cubisino A. Lanzaro M. Troian F. Zanconati S. Bernardi B. Fabris N. de Manzini C. Dobrinja |
| author_facet | M. Pastoricchio A. Cubisino A. Lanzaro M. Troian F. Zanconati S. Bernardi B. Fabris N. de Manzini C. Dobrinja |
| author_sort | M. Pastoricchio |
| collection | DOAJ |
| description | Purpose. Aim of the study was to assess the impact of the Italian Society of Anatomic Pathology and Diagnostic Cytology (SIAPEC) classification of 2014, on the treatment of indeterminate thyroid lesions (TIR3). Methods. We retrospectively analyzed patients undergoing thyroid surgery for TIR3 lesions between 2013 and 2018, at the General Surgery Department of Trieste University Hospital. According to the SIAPEC classification, patients were divided into TIR3A and TIR3B groups. All patients treated before 2014 underwent surgical treatment, and surgical specimens were retrospectively classified after revision of fine-needle aspiration cytology. Starting 2014, TIR3A patients were treated only when symptomatic (i.e., coexistent bilateral thyroid goiter or growing TIR3A nodules), whereas TIR3B patients always received surgical treatment. Hemithyroidectomy (HT) was the procedure of choice. Total thyroidectomy (TT) was performed in case of concurrent bilateral goiter, autoimmune thyroid disease, and/or presence of BRAF and/or RAS mutation. Lastly, we analyzed the malignancy rate in the two groups. Results. 29 TIR3A and 90 TIR3B patients were included in the study. HT was performed in 10 TIR3A patients and 37 TIR3B patients, respectively, with need for reoperation in 4 TIR3B (10.8%) patients due to histological findings of follicular thyroid carcinoma >1 cm. The malignancy rates were 17.2% in TIR3A and 31.1% in TIR3B, (p=0.16). Predictability of malignancy was almost 89% in BRAF mutation and just 47% in RAS mutation. Conclusions. The new SIAPEC classification in association with biomolecular markers has improved diagnostic accuracy, patient selection, and clinical management of TIR3 lesions. |
| format | Article |
| id | doaj-art-d04a149757234d40906020cd7e7c0a02 |
| institution | DOAJ |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-d04a149757234d40906020cd7e7c0a022025-08-20T03:19:46ZengWileyInternational Journal of Endocrinology1687-83371687-83452020-01-01202010.1155/2020/73252607325260Impact of the Italian Society of Anatomic Pathology and Diagnostic Cytology Classification of Thyroid Nodules in the Treatment of Indeterminate Follicular Lesions: Five-Year Results at a Single CenterM. Pastoricchio0A. Cubisino1A. Lanzaro2M. Troian3F. Zanconati4S. Bernardi5B. Fabris6N. de Manzini7C. Dobrinja8Division of Clinical Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste 34149, ItalyDivision of Clinical Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste 34149, ItalyDivision of Clinical Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste 34149, ItalyDivision of Clinical Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste 34149, ItalyDepartment of Medical, Surgical and Health Sciences, Università Degli Studi di Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, ItalyDepartment of Medical, Surgical and Health Sciences, Università Degli Studi di Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, ItalyDepartment of Medical, Surgical and Health Sciences, Università Degli Studi di Trieste, Cattinara Teaching Hospital, Strada di Fiume 447, 34149 Trieste, ItalyDivision of Clinical Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste 34149, ItalyDivision of Clinical Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Cattinara Teaching Hospital, Trieste 34149, ItalyPurpose. Aim of the study was to assess the impact of the Italian Society of Anatomic Pathology and Diagnostic Cytology (SIAPEC) classification of 2014, on the treatment of indeterminate thyroid lesions (TIR3). Methods. We retrospectively analyzed patients undergoing thyroid surgery for TIR3 lesions between 2013 and 2018, at the General Surgery Department of Trieste University Hospital. According to the SIAPEC classification, patients were divided into TIR3A and TIR3B groups. All patients treated before 2014 underwent surgical treatment, and surgical specimens were retrospectively classified after revision of fine-needle aspiration cytology. Starting 2014, TIR3A patients were treated only when symptomatic (i.e., coexistent bilateral thyroid goiter or growing TIR3A nodules), whereas TIR3B patients always received surgical treatment. Hemithyroidectomy (HT) was the procedure of choice. Total thyroidectomy (TT) was performed in case of concurrent bilateral goiter, autoimmune thyroid disease, and/or presence of BRAF and/or RAS mutation. Lastly, we analyzed the malignancy rate in the two groups. Results. 29 TIR3A and 90 TIR3B patients were included in the study. HT was performed in 10 TIR3A patients and 37 TIR3B patients, respectively, with need for reoperation in 4 TIR3B (10.8%) patients due to histological findings of follicular thyroid carcinoma >1 cm. The malignancy rates were 17.2% in TIR3A and 31.1% in TIR3B, (p=0.16). Predictability of malignancy was almost 89% in BRAF mutation and just 47% in RAS mutation. Conclusions. The new SIAPEC classification in association with biomolecular markers has improved diagnostic accuracy, patient selection, and clinical management of TIR3 lesions.http://dx.doi.org/10.1155/2020/7325260 |
| spellingShingle | M. Pastoricchio A. Cubisino A. Lanzaro M. Troian F. Zanconati S. Bernardi B. Fabris N. de Manzini C. Dobrinja Impact of the Italian Society of Anatomic Pathology and Diagnostic Cytology Classification of Thyroid Nodules in the Treatment of Indeterminate Follicular Lesions: Five-Year Results at a Single Center International Journal of Endocrinology |
| title | Impact of the Italian Society of Anatomic Pathology and Diagnostic Cytology Classification of Thyroid Nodules in the Treatment of Indeterminate Follicular Lesions: Five-Year Results at a Single Center |
| title_full | Impact of the Italian Society of Anatomic Pathology and Diagnostic Cytology Classification of Thyroid Nodules in the Treatment of Indeterminate Follicular Lesions: Five-Year Results at a Single Center |
| title_fullStr | Impact of the Italian Society of Anatomic Pathology and Diagnostic Cytology Classification of Thyroid Nodules in the Treatment of Indeterminate Follicular Lesions: Five-Year Results at a Single Center |
| title_full_unstemmed | Impact of the Italian Society of Anatomic Pathology and Diagnostic Cytology Classification of Thyroid Nodules in the Treatment of Indeterminate Follicular Lesions: Five-Year Results at a Single Center |
| title_short | Impact of the Italian Society of Anatomic Pathology and Diagnostic Cytology Classification of Thyroid Nodules in the Treatment of Indeterminate Follicular Lesions: Five-Year Results at a Single Center |
| title_sort | impact of the italian society of anatomic pathology and diagnostic cytology classification of thyroid nodules in the treatment of indeterminate follicular lesions five year results at a single center |
| url | http://dx.doi.org/10.1155/2020/7325260 |
| work_keys_str_mv | AT mpastoricchio impactoftheitaliansocietyofanatomicpathologyanddiagnosticcytologyclassificationofthyroidnodulesinthetreatmentofindeterminatefollicularlesionsfiveyearresultsatasinglecenter AT acubisino impactoftheitaliansocietyofanatomicpathologyanddiagnosticcytologyclassificationofthyroidnodulesinthetreatmentofindeterminatefollicularlesionsfiveyearresultsatasinglecenter AT alanzaro impactoftheitaliansocietyofanatomicpathologyanddiagnosticcytologyclassificationofthyroidnodulesinthetreatmentofindeterminatefollicularlesionsfiveyearresultsatasinglecenter AT mtroian impactoftheitaliansocietyofanatomicpathologyanddiagnosticcytologyclassificationofthyroidnodulesinthetreatmentofindeterminatefollicularlesionsfiveyearresultsatasinglecenter AT fzanconati impactoftheitaliansocietyofanatomicpathologyanddiagnosticcytologyclassificationofthyroidnodulesinthetreatmentofindeterminatefollicularlesionsfiveyearresultsatasinglecenter AT sbernardi impactoftheitaliansocietyofanatomicpathologyanddiagnosticcytologyclassificationofthyroidnodulesinthetreatmentofindeterminatefollicularlesionsfiveyearresultsatasinglecenter AT bfabris impactoftheitaliansocietyofanatomicpathologyanddiagnosticcytologyclassificationofthyroidnodulesinthetreatmentofindeterminatefollicularlesionsfiveyearresultsatasinglecenter AT ndemanzini impactoftheitaliansocietyofanatomicpathologyanddiagnosticcytologyclassificationofthyroidnodulesinthetreatmentofindeterminatefollicularlesionsfiveyearresultsatasinglecenter AT cdobrinja impactoftheitaliansocietyofanatomicpathologyanddiagnosticcytologyclassificationofthyroidnodulesinthetreatmentofindeterminatefollicularlesionsfiveyearresultsatasinglecenter |