Minimally invasive follicular thyroid carcinoma: Completion thyroidectomy or not?

Follicular Thyroid Carcinoma

“…14 FTC with capsular invasion alone should be managed with a more conservative surgical approach in the form of hemithyroidectomy without additional therapy in view of its excellent survival rate. 14,30 On the other hand, the presence of vascular invasion alone increased the disease-specific mortality to 28% at 10 years, 14 although in multivariate analysis, the presence of distant metastases was the only independent prognostic factor for survival. Vascular invasion alone may be a better indication of malignancy than capsular penetration 4,25 because of the greater probability of recurrence and metastases caused by angioinvasion.…”

“…Nevertheless, it remains as a source of confusion because of the different classification and histologic criteria used by different pathologists. 27,30 Apart from classifying the tumors into intrathyroidal or extrathyroidal based on thyroid capsular extension, 35,37 FTC was more commonly classified as either "minimally invasive encapsulated" or "widely invasive" by the Armed Forces Institute of Pathology classification, 28 which followed the WHO guidelines. 24 A diagnosis of minimally invasive carcinoma can be made either on the basis of capsular invasion alone, vascular invasion alone, or the presence of both types of invasions.…”

“…14,28 -30 The need of subclassifying minimally invasive carcinoma into tumors with capsular invasion alone (truly minimally invasive) or with angioinvasion (moderately invasive or angioinvasive) remains controversial. 17,[27][28][29][30] The purpose of the present study was to document the prognostic factors for survival specific to FTC with the incorporation of histologic subclassification according to the type and extent of invasion. The role of histologic types in predicting survival as well as in the management of patients with FTC was studied.…”

Can Minimally Invasive Follicular Thyroid Cancer be Approached as a Benign Lesion?

“…1,3,5,10,12,14 Other authors have emphasized that MIFC can indeed metastasize; therefore, they recommend total thyroidectomy followed by radioactive iodine (RAI) ablation. 9,15,16 To date, there has been a paucity of population level data regarding MIFC. Most studies about MIFC have come from single-institutional series and have not enrolled more than 100 patients.…”

Minimally invasive follicular thyroid carcinoma

“…Bei angioinvasiven MIFTC sind die Empfehlungen daher unterschiedlich. Einige Autoren [33,35] sehen eine (Komplettierungs)Thyre oidektomie für nicht angebracht, ande re sehr wohl, weil sie aufgrund der po tenziellen Metastasierung eine Radiojod ablation für notwendig erachten [11]. Neuere Studien [21] konnten auf der Ba sis früherer Erkenntnisse [32] …”