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Patients with Non-invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features are Unlikely to have Malignant Preoperative Cytology

  • Endocrine Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The newly termed tumor ‘noninvasive follicular thyroid neoplasm with papillary-like nuclear features’ (NIFTP) acts in an indolent manner and can likely be safely managed with a thyroid lobectomy. Preoperative fine-needle aspiration (FNA) is the cornerstone of surgical planning, but the ability of FNA to distinguish NIFTP from other variants of papillary thyroid carcinoma (PTC) has not been well-evaluated.

Methods

A 9-year retrospective review of the preoperative cytology and surgical pathology of PTC patients who underwent a thyroidectomy at our tertiary referral center.

Results

Overall, 174 patients with 177 PTCs had a preoperative FNA followed by a thyroidectomy, and met our inclusion criteria. Of the 21 patients with NIFTP, the preoperative cytology was read as malignant in three (14%), suspicious for malignancy in three (14%), follicular neoplasm in ten (48%), atypia of undetermined significance in four (19%), and benign in one (5%) nodule. When comparing patients with NIFTP with other variants of PTC, patients with NIFTP were younger (p = 0.023) and less likely to have malignant cytology (p < 0.001). On multivariable regression modeling, malignant cytology was independently associated with a decreased risk of a final diagnosis of NIFTP (odds ratio 0.064, 95% confidence interval 0.018–0.233, p < 0.001).

Conclusions

Patients with a final diagnosis of NIFTP are less likely to have preoperative FNA diagnosis of malignancy than those with final pathology of classical or other variants of PTC. Surgeons should take this into consideration when considering between a lobectomy and total thyroidectomy for patients with suspected PTC.

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Funding

Department funds were used for incidental expenses.

Conflicts of interest

Richa Singh, Jorge Avila, Kahee Jo, Kevin T.K. Nguyen, Nika Roa Carrillo, Eric C. Huang, and Michael J. Campbell have no conflicts of interest to disclose.

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Author notes

  1. Eric C. Huang and Michael J. Campbell have contributed equally to this work as senior authors.

Authors and Affiliations

  1. Department of Medicine, University of California, Davis Medical Center, Sacramento, CA, USA

    Richa Singh MD

  2. Department of Surgery, University of California, Davis Medical Center, Sacramento, CA, USA

    Jorge Avila BS, Kahee Jo BS, Kevin T. K. Nguyen BS, Nika Roa Carrillo BS & Michael J. Campbell MD

  3. Department of Pathology and Laboratory Medicine, University of California, Davis Medical Center, Sacramento, CA, USA

    Eric C. Huang MD, PhD

  4. Davis Comprehensive Cancer Center, University of California, Davis Medical Center, Sacramento, CA, USA

    Michael J. Campbell MD

Authors
  1. Richa Singh MD
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  2. Jorge Avila BS
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  3. Kahee Jo BS
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  4. Kevin T. K. Nguyen BS
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  5. Nika Roa Carrillo BS
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  6. Eric C. Huang MD, PhD
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  7. Michael J. Campbell MD
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Corresponding author

Correspondence to Michael J. Campbell MD.

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Singh, R., Avila, J., Jo, K. et al. Patients with Non-invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features are Unlikely to have Malignant Preoperative Cytology. Ann Surg Oncol 24, 3300–3305 (2017). https://doi.org/10.1245/s10434-017-6038-5

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  • DOI: https://doi.org/10.1245/s10434-017-6038-5

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