Surgical treatment of thyroid follicular neoplasms: results of a retrospective analysis of a large clinical series
| Autor: | Maria Rosa Pelizzo, Piergiorgio Calò, Giancarlo Troncone, Maurizio De Palma, Angela Pezzolla, Giovanni Conzo, Chiara Dobrinja, Giuseppe Signoriello, Marica Grasso, Giuseppe Siciliano, Gian Luca Ansaldo, Lodovico Rosato, Claudio Gambardella, Luciano Pezzullo, Mario Testini, Micaela Piccoli, Nicola Avenia, Celestino Pio Lombardi, Stefano Spiezia, Ernesto Tartaglia, Francesco Tartaglia, Giovanni Docimo |
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| Přispěvatelé: | Conzo, Giovanni, Avenia, Nicola, Ansaldo, Gian Luca, Calò, Piergiorgio, De Palma, Maurizio, Dobrinja, Chiara, Docimo, Giovanni, Gambardella, Claudio, Grasso, Marica, Lombardi, Celestino Pio, Pelizzo, Maria Rosa, Pezzolla, Angela, Pezzullo, Luciano, Piccoli, Micaela, Rosato, Lodovico, Siciliano, Giuseppe, Spiezia, Stefano, Tartaglia, Ernesto, Tartaglia, Francesco, Testini, Mario, Troncone, Giancarlo, Signoriello, Giuseppe, Conzo, G., Avenia, N., Ansaldo, G. L., Calo, P., De Palma, M., Dobrinja, C., Docimo, G., Gambardella, C., Grasso, M., Lombardi, C. P., Pelizzo, M. R., Pezzolla, A., Pezzullo, L., Piccoli, M., Rosato, L., Siciliano, G., Spiezia, S., Tartaglia, E., Tartaglia, F., Testini, M., Troncone, G., Signoriello, G., de Palma, Maurizio |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Fine needle cytology Follicular neoplasm Hemithyroidectomy Thyroid cancer Total thyroidectomy Endocrinology Diabetes and Metabolism medicine.medical_treatment Thyroid Gland Thyroiditis Postoperative Complications 0302 clinical medicine Endocrinology Risk Factors Retrospective Studie Adenocarcinoma Follicular Thyroid Neoplasm Adult Aged Female Humans Hypoparathyroidism Middle Aged Retrospective Studies Thyroid Neoplasms Thyroidectomy Treatment Outcome Thyroid Diabetes and Metabolism medicine.anatomical_structure 030220 oncology & carcinogenesis Human Thyroid nodules medicine.medical_specialty 030209 endocrinology & metabolism Adenocarcinoma Malignancy 03 medical and health sciences medicine business.industry Risk Factor Follicular medicine.disease Surgery Endocrine surgery Postoperative Complication business |
| Popis: | The most appropriate surgical management of "follicular neoplasm/suspicious for follicular neoplasm" lesions (FN), considering their low definitive malignancy rate and the limited predictive power of preoperative clinic-diagnostic factors, is still controversial. On behalf of the Italian Association of Endocrine Surgery Units (U.E.C. CLUB), we collected and analyzed the experience of 26 endocrine centers by computerized questionnaire. 1379 patients, surgically treated after a FN diagnosis from January 2012 and December 2103, were evaluated. Histological features, surgical complications, and medium-term outcomes were reported. Total thyroidectomy (TT) was performed in 1055/1379 patients (76.5 %), while hemithyroidectomy (HT) was carried out in 324/1379 cases (23.5 %). Malignancy rate was higher in TT than in HT groups (36.4 vs. 26.2 %), whereas the rates of transient and definitive hypoparathyroidism following TT were higher than after HT. Consensual thyroiditis (16.8 vs. 9.9 %) and patient age (50.9 vs. 47.9 %) also differed between groups. A cytological FN diagnosis was associated to a not negligible malignancy rate (469/1379 patients; 34 %), that was higher in TT than in HT groups. However, a lower morbidity rate was observed in HT, which should be considered the standard of care in solitary lesions in absence of specific risk factors. Malignancy could not be preoperatively assessed and clinical decision-making is still controversial. Further efforts should be spent to more accurately preoperatively classify FN thyroid nodules. The most appropriate surgical management of “follicular neoplasm/suspicious for follicular neoplasm” lesions (FN), considering their low definitive malignancy rate and the limited predictive power of preoperative clinic-diagnostic factors, is still controversial. On behalf of the Italian Association of Endocrine Surgery Units (U.E.C. CLUB), we collected and analyzed the experience of 26 endocrine centers by computerized questionnaire. 1379 patients, surgically treated after a FN diagnosis from January 2012 and December 2103, were evaluated. Histological features, surgical complications, and medium-term outcomes were reported. Total thyroidectomy (TT) was performed in 1055/1379 patients (76.5 %), while hemithyroidectomy (HT) was carried out in 324/1379 cases (23.5 %). Malignancy rate was higher in TT than in HT groups (36.4 vs. 26.2 %), whereas the rates of transient and definitive hypoparathyroidism following TT were higher than after HT. Consensual thyroiditis (16.8 vs. 9.9 %) and patient age (50.9 vs. 47.9 %) also differed between groups. A cytological FN diagnosis was associated to a not negligible malignancy rate (469/1379 patients; 34 %), that was higher in TT than in HT groups. However, a lower morbidity rate was observed in HT, which should be considered the standard of care in solitary lesions in absence of specific risk factors. Malignancy could not be preoperatively assessed and clinical decision-making is still controversial. Further efforts should be spent to more accurately preoperatively classify FN thyroid nodules. |
| Databáze: | OpenAIRE |
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