Overview of the 2022 WHO Classification of Thyroid Neoplasms

Baloch, Zubair W.; Sylvia, L.; Barletta, Justine A.; Xu, Bin; Juhlin, C. Christofer; Jung, Chan Kwon; LiVolsi, Virginia A.; Papotti, Mauro; Sobrinho-Simões, Manuel; Tallini, Giovanni; Mete, Özgür

doi:10.1007/s12022-022-09707-3

Cited by 610 publications

(685 citation statements)

References 276 publications

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“…In the upcoming WHO classification 5th edition, the definition of PTC-SV requires >50% STI. 15 Further complicating the issue is the definition of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP), which introduces another cutoff of STI, being 30% to exclude a NIFTP diagnosis. 16,17 Not surprisingly, the diagnostic criteria of PTC-SV vary, ranging from 50%, 3,5,12,13 70%, 4 75%, 10 80%, 18 to 100% 11 STI.…”

Section: Introductionmentioning

confidence: 99%

The solid variant of papillary thyroid carcinoma: a multi‐institutional retrospective study

Viswanathan

Zhang

et al. 2022

Histopathology

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Aims The definition of papillary thyroid carcinoma, solid variant (PTC‐SV) varies from >50% to 100% of solid/trabecular/insular growth (STI). We aimed to identify prognostic factors and to establish an appropriate STI cutoff for PTC‐SV in this multi‐institutional study of 156 PTCs with STI. Results Nodal metastases were seen in 18% and were associated with a higher percentage of papillary and STI. When substratified by infiltration/encapsulation status, the STI percentage did not impact the risk of nodal metastasis. pN1 stage was seen in 51% of infiltrative tumours and 1% of encapsulated lesions. Overall, PTC with STI had an excellent prognosis. The 10‐year disease‐free survival (DFS) was 87% in the entire cohort, 94% in encapsulated lesions, and 76% in infiltrative tumours. The STI percentage did not impact DFS. Fifty‐four patients had noninvasive encapsulated lesions with 2–100% STI. None developed recurrence. Encapsulated lesions were enriched with RAS mutations (54%), whereas infiltrative lesions lacked RAS mutations (4%). The BRAF V600E mutation was an infrequent event, being seen in 11% of the entire cohort. Conclusion In PTC with STI, the determining factor for nodal metastasis and DFS is the encapsulation/infiltration status rather than the STI percentage. Encapsulated noninvasive tumours with STI follow an indolent course with a very low risk of nodal metastasis and recurrence. Overall, PTC with STI has an excellent prognosis, with a 10‐year disease‐specific survival (DSS) and DFS of 96% and 87%, respectively. Therefore, the classification of SV‐PTC as an aggressive PTC subtype may be reconsidered.

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Section: Introductionmentioning

confidence: 99%

The solid variant of papillary thyroid carcinoma: a multi‐institutional retrospective study

Viswanathan

Zhang

et al. 2022

Histopathology

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“…Most patients can be cured by almost all thyroidectomy and neck lymph node dissection, and 131 I is used for postoperative ablation of occult microlesions. However, there are still 15-30% of patients with local recurrence and cervical lymph node metastasis (LNM) (1)(2)(3). More than 96% of potential driver mutations in PTC have been identified, which can lead to special histological features or biological behavior (4).…”

Section: Introductionmentioning

confidence: 99%

Ultrasonography-Guided Thermal Ablation for Cervical Lymph Node Metastasis of Recurrent Papillary Thyroid Carcinoma: Is it Superior to Surgical Resection?

Zhang

2022

Front. Endocrinol.

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AimThe study aimed to systematically evaluate the safety and efficacy of ultrasonography-guided percutaneous thermal ablation in the treatment of cervical lymph node metastasis (LNM) of recurrent papillary thyroid carcinoma (PTC).MethodsPubMed, PubMed Central (PMC), Embase, and Cochrane were examined. The inclusion and exclusion criteria were determined and the relevant data were extracted from the library and other databases for LNM thermal ablation of recurrent PTC. The data were analyzed using Stata15.1, Revman5.3 software, and the standard errors of 95% confidence intervals were estimated using fixed or random effects models. Volume reduction rate (VRR), Serum thyroglobulin (Tg) level before and after thermal ablation, the total complications and major complications incidence were analyzed.ResultsA total of 18 literature articles were included, namely, 10 radiofrequency ablation (RFA), 4 laser ablation (LA), and 4 microwave ablation (MWA). A total of 321 patients had 498 LNM. LNM volume changes before and at the last follow-up of thermal ablation (SMD = 1.04, I2 = 8%, 95% CI 0.86–1.21, P <0.0001). The postoperative lymph node VRR was 88.4% (95% CI 77.8–97.3%, I2 = 34%, P = 0.14). Tg measurements before and after thermal ablation (SMD = 1.15, 95% CI 0.69–1.60, I2 = 84%, P <0.0001). The incidence of total complications was 5.0% (95% CI 3.0–7.0%, I2 = 0.0%, P = 0.915), and the incidence of major complications was 4.0% (95% CI 2.0–6.0%, I2 = 0.0%, P = 0.888). A total of 131 LNM were located in the central region, and the major complication rate was 12.0% (95% CI 6.0–18.0%, I2 = 0.0%, P = 0.653).ConclusionUltrasonography-guided thermal ablation is safe and effective in the treatment of LNM of recurrent PTC. The ablation strategy of central LNM needs to be further explored and improved. It can be used as an alternative to surgery for patients with high surgical risk or who refuse resurgery.Systematic Review Registration10.37766/inplasy2022.6.0004, identifier INPLASY202260004.

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“…Although PTC is considered to have an excellent prognosis, with a 10-year relative survival rate of 98% in cases with localized disease, some histological variants of PTC have shown a more aggressive profile, with reduced overall survival rates [ 3 ]. These aggressive subtypes include the tall cell (TC), columnar cell (CC), and hobnail subtype (HPTC) [ 4 ]. These correlate with higher rates of recurrence and metastasis and in some cases with refractoriness to radioiodine treatment [ 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Hobnail Papillary Thyroid Carcinoma, A Systematic Review and Meta-Analysis

Spyroglou

Kostopoulos

Tseleni

et al. 2022

Cancers

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Although papillary thyroid carcinoma (PTC) is considered to have an excellent prognosis, some recently identified more aggressive variants show reduced overall survival rates. Hobnail PTC (HPTC) was newly recognized as one of these aggressive forms, affecting recurrence, metastasis, and overall survival rates. Herein, we performed a systematic review and meta-analysis of studies including cases or case series with patients with HPTC. Furthermore, we included our individual case series consisting of six patients. The pooled mortality rate in the cohort, consisting of 290 patients, was 3.57 (95% CI 1.67–7.65) per 100 person/years. No sex differences could be observed concerning mortality (p = 0.62), but older age and tumor size significantly affected mortality (p = 0.004 and p = 0.02, respectively). The percentage of hobnail cells did not affect mortality (p = 0.97), neither did the presence of BRAF mutations. Classical characteristics such as the presence of extrathyroidal extension (p = 0.001), distant metastases (p < 0.001), and lymph node metastases (p < 0.001) all had a significant impact on mortality. Thus, HPTC appears to correlate with worse overall survival, and all PTC cases should be carefully assessed for this variant.

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Overview of the 2022 WHO Classification of Thyroid Neoplasms

Cited by 610 publications

References 276 publications

The solid variant of papillary thyroid carcinoma: a multi‐institutional retrospective study

The solid variant of papillary thyroid carcinoma: a multi‐institutional retrospective study

Ultrasonography-Guided Thermal Ablation for Cervical Lymph Node Metastasis of Recurrent Papillary Thyroid Carcinoma: Is it Superior to Surgical Resection?

Hobnail Papillary Thyroid Carcinoma, A Systematic Review and Meta-Analysis

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