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Endocrine

, Volume 49, Issue 1, pp 191–195 | Cite as

Differentiated thyroid cancer patients with a previous indeterminate (Thy 3) cytology have a better prognosis than those with suspicious or malignant FNAC reports

  • Pierpaolo Trimboli
  • Massimo Bongiovanni
  • Fabio Rossi
  • Leo Guidobaldi
  • Anna Crescenzi
  • Luca Ceriani
  • Giuseppe Nigri
  • Stefano Valabrega
  • Francesco Romanelli
  • Luca Giovanella
Original Article

Abstract

The prognosis of differentiated thyroid cancers (DTC) read at cytology as indeterminate and classified as Thy 3 according to the British Thyroid Association has recently been suggested to be good. To obtain robust information about this potential novelty, in this study we retrospectively reviewed DTC with a prior fine-needle aspiration cytology (FNAC) of Thy 3, Thy 4 or Thy 5 presently followed up at two institutes. Patients with no FNAC before surgery were excluded and a series of 284 DTC was enrolled in the study. Of these, 53 had Thy 3, 108 Thy 4, and 123 had Thy 5 prior to surgery. At histology, 280 (98.6 %) papillary and 4 follicular (1.4 %) cancers were found. Overall, the less aggressive cancer forms were prevalent in all three groups. The lower TNM stages (I and II) were more frequent in the Thy 3 group (96.2 %) than in the other cases (76.6 %) (p < 0.001). Neck lymph node metastasis at diagnosis was found in 3.8 % of Thy 3, 18.5 % of Thy 4, and 26 % of Thy 5 cases. At follow-up, a 16.2 % recurrence rate was recorded, ranging from 1.9 % in Thy 3 group to 19.5 % for Thy 4 and Thy 5 (p < 0.001). According to the Kaplan–Meier curve, Thy 3 was thus a favorable prognostic factor compared with Thy 4 and Thy 5 (OR = 0.079, p < 0.001, 95 %CI 0.01–0.59). At multivariate analysis, Thy 3 was an independent predictor of good prognosis (OR = 0.06, p = 0.03, 95 %CI 0.01–0.80). In conclusion, DTC with a preoperative Thy 3 cytology have a better prognosis than those with Thy 4 and Thy 5 due to less aggressive tumor types and lower TNM stage at diagnosis.

Keywords

Thyroid cancer Cytology FNAC Prognosis Thy 3 

Notes

Conflict of interest

The authors have no conflicts of interest to declare.

Supplementary material

12020_2014_453_MOESM1_ESM.tif (304 kb)
Supplementary material 1 (TIFF 303 kb)

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Pierpaolo Trimboli
    • 1
    • 2
  • Massimo Bongiovanni
    • 3
  • Fabio Rossi
    • 1
  • Leo Guidobaldi
    • 4
  • Anna Crescenzi
    • 5
  • Luca Ceriani
    • 2
  • Giuseppe Nigri
    • 6
  • Stefano Valabrega
    • 6
  • Francesco Romanelli
    • 7
  • Luca Giovanella
    • 2
  1. 1.Section of Endocrinology and DiabetologyOspedale IsraeliticoRomeItaly
  2. 2.Department of Nuclear Medicine and Thyroid CentreOncology Institute of Southern SwitzerlandBellinzonaSwitzerland
  3. 3.Institute of PathologyUniversity HospitalLausanneSwitzerland
  4. 4.Section of PathologyOspedale IsraeliticoRomeItaly
  5. 5.Section of PathologyUniversity Hospital Campus Bio MedicoRomeItaly
  6. 6.Department of Medical and Surgical Sciences, Ospedale S. AndreaSapienza UniversityRomeItaly
  7. 7.Department of Experimental MedicineSapienza UniversityRomeItaly

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