Is FNAC (Fine Needle Aspiration Cytology) a Useful Tool in Detection of Malignancy in Thyroid Surgery ? A Single Institution Experience

Heyman, Sydney; Pirenne, Y; Elst, F. Van; Vervloessem, Dirk; Vanderveken, M; Willemsen, Paul

doi:10.1080/00015458.2014.11680992

Acta Chirurgica Belgica

2014

DOI: 10.1080/00015458.2014.11680992

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Is FNAC (Fine Needle Aspiration Cytology) a Useful Tool in Detection of Malignancy in Thyroid Surgery ? A Single Institution Experience

Sydney Heyman

Y Pirenne

F. Van Elst

et al.

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“…Our aim was to identify and manage these patients surgically. Despite FNA being the gold standard for preoperative assessment of thyroid nodules, it seems to have a significant percentage of false-negative results for malignancy, ranging from 1-11%, due to various reasons such as the nodule size [3,4], the techniques used by the histopathologists and the experience of both the physician performing FNA and the pathologist [5,6]. Moreover, occult cancer can be found in unsuspected sites of the specimen.…”

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confidence: 92%

Occult cancer after thyroidectomy for benign thyroid disorders. Is total thyroidectomy justified based on these grounds?

et al. 2015

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Background: It is well known that thyroid nodules are common among the general population. Despite the fact that only 4-8% are clinically detectable, a higher percentage ranging between 13-67% are identified with ultrasonography. Many studies have shown that malignancy can be detected in 5% of these nodules irrespective of their size. Nowadays, total thyroidectomy seems to be the most appropriate operation, even for benign thyroid diseases. We conducted this prospective study in order to assess the true incidence of occult thyroid cancer in benign thyroid disease specimens and explore any associated factors. Finally, we wanted to appraise whether total thyroidectomy is indeed justified based on these grounds.

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Occult cancer after thyroidectomy for benign thyroid disorders. Is total thyroidectomy justified based on these grounds?

et al. 2015

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Limitation of intraoperative frozen section during thyroid surgery

Estebe

Montenat

Tremoureux

et al. 2016

Eur Arch Otorhinolaryngol

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Retrospective analysis on 312 patients, operated for thyroid nodules between 2014 and 2015, was conducted to evaluate the impact of frozen section analysis on the strategy of thyroid nodule surgery. One hundred and ninety-three patients were included. They all underwent preoperative US, fine needle aspiration cytology (FNAC), per operative frozen section (FS) and post operative definitive pathological analysis. Se, Sp, VPP and VPN of FNAC and FS were calculated and compared (McNemar's test). Multivariate analysis was performed to identify independent factor of good results. Se of FS and FNAC were, respectively, 86.1 and 81% with significant superiority of FS (p = .0352). Sp of FS and FNAC were, respectively, 100 and 72% with significant superiority of FS (p = .0156). A strategy based only on FNAC would have led to a 3.6% rate of unnecessary total thyroidectomy vs. 0% using FS. Overall rate of second procedure after lobectomy would have been significantly greater 28.9% without (28.9%) than with (10.3%) FS (p = .018). Overall rate of undone one-stage central neck dissection concurrent to total thyroidectomy for MNG would not have been significantly different without (9.4%) and with (2.1%) FS (.058). FNAC alone is unable to determine the extent of thyroid nodule surgery whatever the Bethesda subtype may be. FS significantly decreases the risk of two-stage procedure. For one-stage total thyroidectomy for MNG, the gain with FS is scarce.

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Is FNAC (Fine Needle Aspiration Cytology) a Useful Tool in Detection of Malignancy in Thyroid Surgery ? A Single Institution Experience

Cited by 2 publications

References 1 publication

Occult cancer after thyroidectomy for benign thyroid disorders. Is total thyroidectomy justified based on these grounds?

Occult cancer after thyroidectomy for benign thyroid disorders. Is total thyroidectomy justified based on these grounds?

Limitation of intraoperative frozen section during thyroid surgery

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