Thyroid papillary cancers: microcarcinoma and carcinoma, incidental cancers and non‐incidental cancers – are they different diseases?

Bari, Lorenzo Di; Simi, U; Meucci, Giuseppe; Lapi, Paola; Orsini, Paola; Pasquini, Cristina

doi:10.1111/j.1365-2265.2005.02386.x

Cited by 59 publications

(57 citation statements)

References 32 publications

(39 reference statements)

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“…Their findings suggest that these lesions, even when multifocal, seem to have an indolent natural history distinct from that of larger tumours. 24,26,28,29 Both our findings and findings from these studies contradict traditional clinical practice and training, which promotes total thyroidectomy as the optimal surgical procedure for the management of all differentiated thyroid carcinomas. 30,31 Although the percentage may be less in Canada, several US studies suggest that as many as 85% of patients with papillary carcinomas undergo total thyroidectomy regardless of the size of the tumour.…”

contrasting

confidence: 53%

Increased incidence of differentiated thyroid carcinoma and detection of subclinical disease

Kent¹,

Hall²,

Isotalo³

et al. 2007

Canadian Medical Association Journal

250

188

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contrasting

confidence: 53%

Increased incidence of differentiated thyroid carcinoma and detection of subclinical disease

Kent¹,

Hall²,

Isotalo³

et al. 2007

Canadian Medical Association Journal

250

188

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“…Microcalcifications within malignant nodules have been observed in many studies (76,(127)(128)(129)(130) and were present in 7.1-59% of patients with PTMC (76,(127)(128)(129)(130)(131). Irregular margins of the nodules have been observed in 21.5-77% of PTMC (11,127,130,133). A taller-than wider dimension and antero-posterior diameter larger than the transverse diameter of nonpalpable thyroid nodules have also been suggested as a diagnostic feature for the presence of malignancy (76,101).…”

Section: Diagnosis Of Ptmcmentioning

confidence: 97%

“…Total/near total thyroidectomy was carried out in 100% of the cases in 17 (11,12,14,15,18,24,26,27,39,46,49,52,97,104,106,117,150) out of 44 studies that reported the type of surgery (4-6, 8, 11, 12, 14-18, 20, 23-27, 30-32, 34, 38-40, 42, 45, 46, 48-50, 58, 97, 98, 104-106, 114, 117, 121, 123, 124, 143, 148, 150). Combining the results of different studies that clearly reported the extent of surgery in 9259 patients with PTMC, total/near total thyroidectomy was performed in the 72%, subtotal thyroidectomy in the 11% and lobectomy in the 17% of the cases (4-6, 8, 11, 12, 14-18, 20, 23-27, 30-32, 34, 38-40, 42, 45, 46, 48-50, 58, 97, 98, 104-106, 114, 117, 121, 123, 124, 143, 148, 150).…”

Section: Surgical Proceduresmentioning

confidence: 99%

Thyroid papillary microcarcinoma: a descriptive and meta-analysis study

Roti

Uberti

Bondanelli

et al. 2008

European Journal of Endocrinology

287

229

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The authors review anatomical, clinical characteristics and prevalence of thyroid microcarcinoma. Diagnostic procedures and risk factors of aggressiveness at diagnosis and during follow-up are also covered. The possible clinical, pathologic and therapeutic risk factors are analyzed by meta-analysis study. Treatment procedures by different authors and guidelines suggested by societies are reported.European Journal of Endocrinology 159 659-673

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“…It has been proposed that incidental cancer found by histological examination of goiters would hold lower potential aggressiveness than cancers detected by fine-needle aspiration considering prognostic features, such as multifocality, lymph node metastasis and extracapsular invasion (29). On the other hand, there are many reports on the aggressive behavior of papillary microcarcinomas, which evolve not only with lymphatic regional metastases, but also with blood-borne lung, bone and brain metastases (30,31).…”

Section: Thyroid Cancer Biologymentioning

confidence: 99%

Identifying a risk profile for thyroid cancer

Ward

Morari

Leite

et al. 2007

Arq Bras Endocrinol Metab

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The large use of simple and effective diagnostic tools has significantly contributed to the increase in diagnosis of thyroid cancer over the past years. However, there is compelling evidence that most micropapillary carcinomas have an indolent behavior and may never evolve into clinical cancers. Therefore, there is an urgent need for new tools able to predict which thyroid cancers will remain silent, and which thyroid cancers will present an aggressive behavior. There are a number of well-established clinical predictors of malignancy and recent studies have suggested that some of the patient's laboratory data and image methods may be useful. Molecular markers have also been increasingly tested and some of them appear to be very promising, such as BRAF, a few GST genes and p53 polymorphisms. In addition, modern tools, such as immunocytochemical markers, and the measure of the fractal nature of chromatin organization may increase the specificity of the pathological diagnosis of malignancy and help ascertain the prognosis. Guidelines designed to select nodules for further evaluation, as well as new methods aimed at distinguishing carcinomas of higher aggressiveness among the usually indolent thyroid tumors are an utmost necessity. O uso cada vez mais freqüente de métodos diagnósticos simples e efetivos tem contribuído significativamente para um aumento no diagnóstico de câncer da tiróide nos últimos anos. Entretanto, existem importantes evidências de que muitos dos microcarcinomas papilíferos têm um comportamento indolente e podem nunca evoluir para cânceres clínicos. Existe, portanto, uma necessidade urgente de desenvolver novas ferramentas capazes de predizer quais os tumores tiroidianos que permanecerão silenciosos e quais desenvolverão comportamento agressivo. Há uma série de marcadores clínicos de evolução bem estabelecidos e alguns estudos recentes sugerem que dados laboratoriais e métodos de imagem podem ser úteis. Marcadores moleculares também vêm sendo ativamente investigados e alguns, como BRAF, os genes GST e polimorfismos de p53, parecem promissores. Além disso, marcadores imunocitoquímicos e a medida da natureza fractal da cromatina podem aumentar a especificidade do diagnóstico anatomopatológico e ajudar a predizer o prognóstico. Existe uma necessidade imperiosa de elaborarmos diretrizes destinadas a selecionar os nódulos que merecem prosseguimento em sua avaliação, assim como novos métodos capazes de identificar lesões mais agressivas entre os geralmente indolentes tumores tiroidianos.

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Thyroid papillary cancers: microcarcinoma and carcinoma, incidental cancers and non‐incidental cancers – are they different diseases?

Cited by 59 publications

References 32 publications

Increased incidence of differentiated thyroid carcinoma and detection of subclinical disease

Increased incidence of differentiated thyroid carcinoma and detection of subclinical disease

Thyroid papillary microcarcinoma: a descriptive and meta-analysis study

Identifying a risk profile for thyroid cancer

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