The new 4th edition World Health Organization classification for thyroid tumors, Asian perspectives

Kakudo, Kennichi; Bychkov, Andrey; Bai, Yanhua; Li, Yaqiong; Liu, Zhiyan; Jung, Chan Kwon

doi:10.1111/pin.12737

Cited by 89 publications

(84 citation statements)

References 204 publications

(605 reference statements)

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“…The changes in ROM following the NIFTP reclassification were summarized in a recent meta‐analysis in which a decrease in ROM was noted in all categories, especially in the indeterminate nodules . Consistent with our present study, it was not surprising that impact of NIFTP reclassification on ROM was more significant in Western than in Asian series …”

Section: Discussionsupporting

confidence: 90%

Differences in surgical resection rate and risk of malignancy in thyroid cytopathology practice between Western and Asian countries: A systematic review and meta‐analysis

Vuong

Ngo

Bychkov

et al. 2019

Cancer Cytopathology

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104

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There is increasing evidence showing that clinicians employ different management strategies in their use of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). In this meta-analysis, we investigated the differences in diagnosis frequency, resection rate (RR), and risk of malignancy (ROM) between Western (ie, American and European) and Asian cytopathology practices. We searched PubMed . Proportion and 95% CIs were calculated using a random-effect model. We used independent sample t tests to compare frequencies, RR, and ROM between Western and Asian practices. We analyzed a total of 38 studies with 145,066 fine-needle aspirations. Compared with Asian practice, Western series had a significantly lower ROM in most of TBSRTC categories, whereas the RR was not statistically different. Focusing on indeterminate nodules, the RR in Western series was significantly higher (51.3% vs 37.6%; P = .048), whereas the ROM was significantly lower (25.4% vs 41.9%; P = .002) compared with those in Asian series. The addition of Asian cohorts increased ROM for most of diagnostic categories compared with the original TBSRTC. In conclusion, this study demonstrates a difference in Western and Asian thyroid cytology practice, especially regarding the indeterminate categories. Lower RR and higher ROM suggest that Asian clinicians adopt a more conservative approach, whereas immediate diagnostic surgery is favored in Western practice for indeterminate nodules. The addition of Asian series into a meta-analysis of TBSRTC altered ROM for several categories, which should be considered in future revisions of TBSRTC.

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Section: Discussionsupporting

confidence: 90%

Differences in surgical resection rate and risk of malignancy in thyroid cytopathology practice between Western and Asian countries: A systematic review and meta‐analysis

Vuong

Ngo

Bychkov

et al. 2019

Cancer Cytopathology

Self Cite

104

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“…The largest study in Japan on FVPTC and NIFTP was conducted in Kuma Hospital [7]; a prevalence of 2.8% for FVPTC and 0.8% for NIFTP was reported. Differences of NIFTP prevalence between Western countries and Asian countries are considered partly due to results of differences in morphological diagnostic criteria for NIFTP [7,20].…”

Section: Discussionmentioning

confidence: 99%

“…The Thyroid Bethesda System also recommends papillary architecture, psammoma bodies, and intranuclear inclusions as cytological parameters of PTC [5]. Especially, true papillae and psammoma type calcification were described as exclusion criteria for histological diagnosis of NIFTP [2,20]. These parameters can help distinguish NIFTP from conventional PTC to some extent.…”

Section: Discussionmentioning

confidence: 99%

Important cytological findings for distinction between follicular variant and conventional papillary thyroid carcinoma, including noninvasive follicular thyroid tumors with papillary-like nuclear features

et al. 2019

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We studied cytological specimens of conventional papillary thyroid carcinoma (PTC), follicular variant papillary thyroid carcinoma (FVPTC), and noninvasive follicular thyroid tumor with papillary-like nuclear features (NIFTP) (formerly noninvasive FVPTC) to identify useful cytological parameters for their differentiation. Cytological findings of invasive FVPTC and NIFTP were very similar to each other but differed from those of conventional PTC. Intranuclear cytoplasmic inclusions, true papillary cell clusters, monolayered cell sheets, ropy colloids, multinucleate giant cells, psammoma bodies, and cystic background were the observed characteristic features of conventional PTC. Microfollicular cell clusters and dense globules of colloids were characteristic features of invasive FVPTC and NIFTP. Scoring the eight parameters (intranuclear cytoplasmic inclusions, nuclear grooves, powdery chromatin, true papillary cell clusters, ropy colloids, multinucleate giant cells, psammoma bodies, and cystic background) readily distinguished NIFTP from conventional PTC, but could not distinguish NIFTP from invasive FVPTC. The average total score of NIFTP, invasive FVPTC, and conventional PTC were 2.60 ± 0.55, 2.63 ± 0.62, and 4.57 ± 0.99, respectively. The difference between conventional PTC and NIFTP or invasive FVPTC was statistically significant (p < 0.001, Student's t-test). Individuals with more than three of the identified parameters likely harbor conventional PTC, rather than NIFTP. In this way, 87.5% (112/128) of conventional PTCs could be differentiated from NIFTP, and definitively diagnosed as malignant by cytology.

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“…Thyroid carcinomas were pathologically classified according to the World Health Organization (WHO) criteria. 18 After surgery, all patients were staged according to the American Joint Committee on Cancer-Tumor-Node-Metastasis (TNM) criteria (seventh edition). 19 Thyroid remnant ablation was performed 4 to 6 weeks after initial thyroidectomy.…”

Section: Treatment Protocolmentioning

confidence: 99%

Analysis of overall survival in differentiated thyroid cancer patients with double primary malignancy

Chi

Wang

et al. 2020

The Kaohsiung J of Med Scie

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Differentiated thyroid cancer (DTC) survivors are at increased risk of developing double primary malignancy (DPM). The aim of this study was to investigate clinicopathological characteristics and survival in DTC patients diagnosed with DPM. A total of 975 patients with DTC diagnosed between 2013 and 2017, treated, and followed at a medical center in Taiwan were retrospectively reviewed. Data from enrolled patients were analyzed for differences in prognosis dependent on the presence of DPM, and which clinicopathological variables affected their prognosis. Among 975 thyroid cancer patients, 94 (9.6%) were diagnosed with DPMs and 16 (1.6%) patients died of any cause. DPM patients had a greater proportion of males, had a higher mean age, more commonly presented with a thyroid mass incidentally by imaging and cervical lymph node metastases, showed a more advanced thyroid cancer stage, and had a higher proportion of lymph node metastases. Overall survival (OS) was significantly lower in patients diagnosed with DPM. Male gender (hazard ratio [HR] = 4.597), two or more DPMs (HR = 8.071), and shorter time interval between two cancers occurrences (HR = 7.101) were significantly risk factors for DPM-related death. In conclusion, the risk of developing DPM in DTC patients was elevated in older, male patients with an advanced tumor-node-metastasis stage. DPM adversely affected the OS of thyroid cancer patients. Male gender, two or more DPMs, and shorter time interval between occurrences were significant risk factors for OS in DPM patients.

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The new 4th edition World Health Organization classification for thyroid tumors, Asian perspectives

Cited by 89 publications

References 204 publications

Differences in surgical resection rate and risk of malignancy in thyroid cytopathology practice between Western and Asian countries: A systematic review and meta‐analysis

Differences in surgical resection rate and risk of malignancy in thyroid cytopathology practice between Western and Asian countries: A systematic review and meta‐analysis

Important cytological findings for distinction between follicular variant and conventional papillary thyroid carcinoma, including noninvasive follicular thyroid tumors with papillary-like nuclear features

Analysis of overall survival in differentiated thyroid cancer patients with double primary malignancy

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