Thyroid Cytology in India: Contemporary Review and Meta-analysis

Agarwal, Shipra; Jain, Deepali

doi:10.4132/jptm.2017.08.04

Cited by 24 publications

(41 citation statements)

References 67 publications

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“…In addition, there are reports of significant variations in ROM in cytological‐histological correlation studies even when the ATA thyroid cancer management guidelines and the Bethesda system were employed . This article presents high quality data provided by members of the Working Group of Asian Thyroid FNA Cytology, which confirms high ROMs in the indeterminate FNA categories and low rates of non‐invasive follicular neoplasm with papillary‐like nuclear features (NIFTP) in most Asian thyroid FNA practice . This article also provides an overview of Asian thyroid FNAC practice and gives possible reasons for the significant differences between Asian and western practice.…”

Section: Introductionmentioning

confidence: 72%

“…Most thyroid aspiration samples were collected by pathologists using manual palpation, and the Bethesda system is the most widely used reporting system in India. This meta‐analysis revealed that ROMs (average and 95% confidence interval) for the six Bethesda categories were 15% (6%‐24%) for non‐diagnostic, 3% (2%‐4%) for benign, 34% (23%‐45%) for AUS/FLUS, 26% (15%‐36%) for FN/SFN, 69% (55%‐84%) for SM and 94% (89%‐98%) for malignant . The average AUS/FLUS ROM for 15 studies was high in Indian practice, whereas the ROMs for FN/SFN and SM categories were within suggested ROMs by the Bethesda system from their meta‐analysis, but different from their own practice (RR of FN/SFN nodules was low at 43.9% and ROM for FN/SFN was high at 72.0%) …”

Section: Review Of Reports By Members Of the Working Group Of Asian Tmentioning

confidence: 94%

“…Agarwal and Jain described their thyroid FNA practice in India, an area with a high prevalence of endemic goitre due to iodine deficiency . Two hundred and fifty (18.7%) patients were surgically‐treated for 1339 FNA nodules, and the ROM for all resected nodules was 58.8% (147/250) and that for all FNA samples was 11.0% (147/1339).…”

Section: Review Of Reports By Members Of the Working Group Of Asian Tmentioning

confidence: 99%

“…They conducted an extensive literature search of reports published from India on thyroid FNAC and found 28 out of 50 studies that met the inclusion criteria for their meta‐analysis . Most thyroid aspiration samples were collected by pathologists using manual palpation, and the Bethesda system is the most widely used reporting system in India.…”

Section: Review Of Reports By Members Of the Working Group Of Asian Tmentioning

confidence: 99%

“…There are two types of clinical practice and reporting systems for thyroid FNAC of thyroid nodules in Asian countries. The majority of Asian countries have established their own guidelines for the management of thyroid nodules/cancer and these national guidelines often endorse the use of ATA guidelines and the Bethesda system . Japan, however, has developed its own clinical guidelines for the treatment of thyroid nodules.…”

Section: Thyroid Fnac In Asiamentioning

confidence: 99%

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Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas

et al. 2017

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Although Asian thyroid practices have implemented the American Thyroid Association guidelines, significant deviations in actual risk of malignancy (ROM) have been reported. With review of the literature from Asia, the authors examine the underlining reasons for actual ROMs reported in Asia being so different from western practice based on the author's perspective. Although the most popular diagnostic system for thyroid cytology used in Asian countries is the Bethesda system, the Japan Thyroid Association published clinical guidelines, including a national reporting system for thyroid cytology, to adapt conservative clinical management (active surveillance and strict triage patients for surgery) for low-risk thyroid carcinomas. As less aggressive clinical management is favoured in Asian societies, strict triage of patients with indeterminate thyroid nodules for surgery is usually applied, which ultimately reduces overtreatment of indolent thyroid tumours. As a result, low resection rates and high ROMs for indeterminate nodules were achieved in Asian practices using the same Bethesda system. Recently, borderline thyroid tumours were introduced in the thyroid tumour classification and significant decreases in ROMs have been reported in the indeterminate categories in western practice.However, ROM of indeterminate nodules remained high in Asian practice even after borderline tumours were deemed benign. These results suggested that the diagnostic threshold of papillary thyroid carcinoma-type nuclear features varied among practices (stricter in Asia than in western practice), and diagnostic surgery was not performed for a significant number of indeterminate nodules with benign clinical features in Asian practice, resulting in low rates of borderline tumours in surgicallytreated patients. K E Y W O R D SAsia, borderline tumour, indeterminate cytology, resection rate, risk of malignancy, thyroid FNAC

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Section: Introductionmentioning

confidence: 72%

Section: Review Of Reports By Members Of the Working Group Of Asian Tmentioning

confidence: 94%

Section: Review Of Reports By Members Of the Working Group Of Asian Tmentioning

confidence: 99%

Section: Review Of Reports By Members Of the Working Group Of Asian Tmentioning

confidence: 99%

Section: Thyroid Fnac In Asiamentioning

confidence: 99%

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Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas

et al. 2017

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Spinal metastases in primary thyroid malignancies: Single center experience of 44 cases

Ahmed,

Jonathan,

Paul

et al. 2024

World j. surg.

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BackgroundPatients with differentiated thyroid carcinoma have a 10 year survival rate of more than 95%. However, the existence of spinal metastases significantly reduces overall survival. In this study, we review the epidemiology and outcomes of patients with thyroid malignancies with spinal metastases.MethodA retrospective analysis was conducted on 44 patients with thyroid malignancy and spinal metastases treated at our institution from 2008 to 2021, evaluating the outcome parameters by analyzing demographic, clinical and radiological profiles.ResultsThe median age upon presentation was 58 years (range ‐ 35 to 80 years). 54.5% had single‐level involvement. The thoracic spine exhibited the highest incidence of involvement, followed by the transitional zones and lumbar spine. The most common presenting features were spinal and radicular pain followed by myelopathy. In 77.3% of cases, the pathology was identified as the follicular variant of papillary thyroid carcinoma. A total of 81.8% of patients underwent total thyroidectomy, with 84% receiving iodine ablation and 61.3% undergoing locoregional radiotherapy. Surgical intervention for spinal metastases was performed in 18 individuals (40.9%). There was significant improvement in the postoperative Visual Analog Scale (VAS) score in the operated group (p‐value of 0.000). Overall, no significant difference was observed in the OS and PFS between the operated and non‐operated groups except for the subset of patients who underwent postoperative radiation therapy (p‐value of 0.013).ConclusionVertebral metastasectomy in primary thyroid malignancies is associated with significant pain relief. Patients who receive postoperative radiotherapy perform better than patients who either undergo metastasectomy or radiation therapy.

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Differences Among Thyroid FNA Practices Elucidated by Meta-analyses of the Literature

Rana,

Vuong

2023

Thyroid FNA Cytology

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Thyroid Cytology in India: Contemporary Review and Meta-analysis

Cited by 24 publications

References 67 publications

Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas

Thyroid FNA cytology in Asian practice—Active surveillance for indeterminate thyroid nodules reduces overtreatment of thyroid carcinomas

Spinal metastases in primary thyroid malignancies: Single center experience of 44 cases

Differences Among Thyroid FNA Practices Elucidated by Meta-analyses of the Literature

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