Are the Clinical and Pathological Features of Differentiated Thyroid Carcinoma Really Changed over the Last 35 Years? Study on 4187 Patients from a Single Italian Institution to Answer this Question

Elisei, Rossella; Molinaro, Eleonora; Agate, Laura; Bottici, Valeria; Masserini, Lucio; Ceccarelli, Claudia; Lippi, Francesco; Grasso, Lucia; Basolo, Fulvio; Bevilacqua, Generoso; Miccoli, Paolo; Coscio, G Di; Vitti, Paolo; Pacini, Furio; Pinchera, Aldo

doi:10.1210/jc.2009-1536

Cited by 205 publications

(146 citation statements)

References 56 publications

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“…As a result of this phenomenon, the frequency of papillary thyroid microcarcinomas (microPTC), defined by the World Health Organization as a PTC of 10 mm or less in the largest dimension (7), has increased considerably during the past two decades (8). The clinical significance of microPTC is still debated, and many authors consider it as a non-progressive disease that has no effect on survival (1), (9,10,11,12,13,14,15,16). On clinical and histological grounds there are two different presentations of microPTC (6): (a) 'incidental' microPTC identified postoperatively at histological examination of thyroid specimens following thyroid surgery for benign disease (i.e.…”

Section: Introductionmentioning

confidence: 99%

“…According to some studies, 'incidental' microPTC have an overall excellent prognosis and there is nearly no risk of recurrence or death (17,18), while 'non incidental' microPTC show a more aggressive behavior, eventually associated with lymph node metastases at presentation, neck loco-regional recurrences during follow-up and/or multifocality of the tumor (6,10,16,19,20). However conflicting results are present in literature to date.…”

Section: Introductionmentioning

confidence: 99%

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‘Incidental’ and ‘non-incidental’ thyroid papillary microcarcinomas are two different entities

Provenzale

Fiore

Ugolini

et al. 2016

European Journal of Endocrinology

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Objective Papillary thyroid microcarcinomas (microPTC) may be ’incidental’ (Inc-microPTC), occasionally found at histology after surgery for benign disease or ‘non-incidental’ (Non-Inc-microPTC), diagnosed on clinical grounds. It is unclear whether these different microPTC reflect the same disease. The aim of the study was to compare Inc-microPTC and Non-Inc-microPTC for clinical and histological features as well as for serum TSH, a known factor involved in PTC development. Design We evaluated histology and serum TSH levels of consecutive patients submitted to thyroidectomy for goiter with compressive symptoms or for cytological diagnosis suspicious/indicative of PTC. Methods In total, 665 consecutive patients (259 with a single thyroid nodule, SN and 406 with a multinodular gland, MN) were included in the study. According to histology, patients were classified as: benign nodular goiter (Benign, n=291); Inc-microPTC (n=92); Non-Inc-microPTC (n=67) and PTC≥1cm (macroPTC, n=215). Results Inc-microPTC were significantly more frequent in MN than in SN (66/406, 16.2% vs 26/259, 10.0%, P=0.02). Patients with Inc-microPTC compared with Non-Inc-microPTC were older (mean age±s.d. 53.3±13.2 years vs 44.9±14.8 years, P=0.0002), had a smaller tumor size (median 4mm vs 9mm, P<0.0001), a higher frequency of multifocality (70/92, 76.1% vs 35/67, 52.2% P=0.001) and lower levels of TSH (median 0.6mIU/L, IR: 0.4–1.0mIU/L vs value 1. mIU/L, IR: 0.6–1.4mIU/L vs P=0.0001). Conclusion Incidental and non-incidental papillary thyroid microcarcinomas appear to be two different entities.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

‘Incidental’ and ‘non-incidental’ thyroid papillary microcarcinomas are two different entities

Provenzale

Fiore

Ugolini

et al. 2016

European Journal of Endocrinology

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“…Other distant metastases are rare or relatively rare and involve the brain, breast, liver, kidney, muscle, and skin. The presence of distant metastases is the most significant poor prognostic factor for survival, with only 50% metastatic patients surviving after 10 years (Elisei et al 2010). Among the factors responsible for distant metastases and increased mortality in patients with DTC are age over 45 years and the involvement of multiple organs, both are independently associated with cancer mortality (Ruegemer et al 1988).…”

Section: Introductionmentioning

confidence: 99%

Rare metastases of differentiated thyroid carcinoma: pictorial review

Song

Xue²,

Xu³

et al. 2011

Endocrine-Related Cancer

131

148

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Differentiated thyroid cancer (DTC) is usually indolent with good prognosis and long-term survival. However, DTC distant metastasis is often a grave event and accounts for most of its diseasespecific mortality. The major sites of distant metastases are the lung and bone. Metastases to the brain, breast, liver, kidney, muscle, and skin are rare or relatively rare. Nevertheless, recognizing rare metastases from DTC has a significant impact on the clinical decision making and prognosis of patients.131 I single photon emission computed tomography/computed tomography ( 131 I-SPECT/CT) can provide both metabolic and anatomic information about a lesion; therefore, it can better localize and define the 131 I-WBS findings in DTC patients. In this pictorial review, the imaging features of a range of rare metastases from DTC are demonstrated, with a particular emphasis on the 131 I-SPECT/CT diagnostic aspect.

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“…Over the last few decades, there has been an increased incidence of WDTC (primarily papillary carcinoma) with a significant rise from 3.6 per 100,000 in 1973 to 8.7 per 100,000 in 2002 in United States (US), a 2.4-fold increase (p<0.001 for trend) with a crescendo pattern (Davies and Welch, 2002). Similar increases have also been reported in Europe (Elisei et al, 2010). Importantly most of these tumors were diagnosed at a smaller size (49% tumors were ≤1cm and 87% were ≤2cm) and 58% of patients were aged <50 years (median age=46 years) (Edwards et al, 2002).…”

Section: Introductionmentioning

confidence: 56%

Controversies about Radioactive Iodine-131 Remnant Ablation in Low Risk Thyroid Cancers: Are We Near A Consensus?

Zaman¹,

Fatima²,

Padhy³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Well differentiated thyroid cancers (WDTC), including papillary (80%) and follicular (10%) types, are the most common endocrine cancers globally. Over the last few decades most the diagnosed cases have fallen into low risk categories. Radioactive iodine-131 (RAI) has an established role in reducing recurrence and improving the survival in high risk patients. In patients with primary tumor size <1 cm, RAI is not recommended by many thyroid societies. However, low risk WDTC has been an arena of major controversies, most importantly the role and dose of adjuvant RAI for remnant ablation to minimize chances of recurrence and improving survival. This review is an attempt to update readers about the previous and existing practice based on results of nonrandomized trials and evolving trends fueled by recently published randomized studies.

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Are the Clinical and Pathological Features of Differentiated Thyroid Carcinoma Really Changed over the Last 35 Years? Study on 4187 Patients from a Single Italian Institution to Answer this Question

Cited by 205 publications

References 56 publications

‘Incidental’ and ‘non-incidental’ thyroid papillary microcarcinomas are two different entities

‘Incidental’ and ‘non-incidental’ thyroid papillary microcarcinomas are two different entities

Rare metastases of differentiated thyroid carcinoma: pictorial review

Controversies about Radioactive Iodine-131 Remnant Ablation in Low Risk Thyroid Cancers: Are We Near A Consensus?

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