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Endocrine

, Volume 66, Issue 3, pp 557–562 | Cite as

Prognosis of patients with differentiated thyroid carcinomas having a preoperative cytological report of indeterminate at low or high risk. A multicenter study

  • Pierpaolo TrimboliEmail author
  • Andrea Palermo
  • Maurilio Deandrea
  • Arnoldo Piccardo
  • Alfredo Campennì
  • Stefano Valabrega
  • Giorgio Grani
  • Giuliano Santolamazza
  • Gianluca Bottoni
  • Agnese Barnabei
  • Valeria Ramundo
  • Rosa Lauretta
  • Lavinia Monte
  • Giulia Ferrarazzo
  • Gaetano Paone
  • Cecilia Crosetto
  • Rosaria Maddalena Ruggeri
  • Sergio Baldari
  • Alfonsina Chiefari
  • Sebastiano Vottari
  • Enrico Giarnieri
  • Eleonora Perrella
  • Paolo Limone
  • Cosimo Durante
  • Luca Giovanella
  • Marialuisa Appetecchia
  • Anna Crescenzi
Original Article
  • 67 Downloads

Abstract

Background

Italian cytology system for thyroid fine-needle aspiration (FNA) includes indeterminate lesions at low- (Tir 3A) and high-risk (Tir 3B). The present retrospective multicenter study was undertaken to compare the histological type of cancers and disease-free survival in these two groups.

Methods

Eight institutions participated. Thyroid cancer patients diagnosed and followed-up after Tir 3A or Tir 3B were reviewed. Histological diagnosis was adopted as the gold standard. Patients were defined with cancer recurrence or no evidence of disease. Disease-free survival (DFS) was calculated. A non-parametric statistical analysis was used. DFS was estimated by Kaplan–Meier method and Hazard Ratio (HR) defined the slope of curves.

Results

Two hundred and nine patients (median DFS 24 months) were enrolled and a 6.3% of these recurred. Tir 3B group had higher age (p = 0.014), larger cancer size (p = 0.0002), shorter DFS (p = 0.003), higher number of aggressive cancers (p = 0.006), and relapse frequency double than Tir 3A. At survival curves analysis, Tir 3B group had HR of 2.37 with respect to Tir 3A. At Cox’s proportional hazard regression analysis histology was the only significant predictor of relapse.

Conclusions

While patients with thyroid FNA of Tir 3B should be addressed to surgery due to high likelihood of more aggressive cancer, a diagnostic surgery could be avoided in patients with Tir 3A if concurrent unsuspicious clinical features are found.

Keywords

Fine-needle aspiration (FNA) Indeterminate nodules Thyroid Carcinoma Follow-up 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Pierpaolo Trimboli
    • 1
    Email author
  • Andrea Palermo
    • 2
  • Maurilio Deandrea
    • 3
  • Arnoldo Piccardo
    • 4
  • Alfredo Campennì
    • 5
  • Stefano Valabrega
    • 6
  • Giorgio Grani
    • 7
  • Giuliano Santolamazza
    • 6
  • Gianluca Bottoni
    • 4
  • Agnese Barnabei
    • 8
  • Valeria Ramundo
    • 7
  • Rosa Lauretta
    • 8
  • Lavinia Monte
    • 3
  • Giulia Ferrarazzo
    • 4
  • Gaetano Paone
    • 1
  • Cecilia Crosetto
    • 3
  • Rosaria Maddalena Ruggeri
    • 9
  • Sergio Baldari
    • 5
  • Alfonsina Chiefari
    • 8
  • Sebastiano Vottari
    • 8
  • Enrico Giarnieri
    • 10
  • Eleonora Perrella
    • 11
  • Paolo Limone
    • 3
  • Cosimo Durante
    • 7
  • Luca Giovanella
    • 1
  • Marialuisa Appetecchia
    • 8
  • Anna Crescenzi
    • 11
  1. 1.Department of Nuclear Medicine and Thyroid CentreEnte Ospedaliero CantonaleBellinzonaSwitzerland
  2. 2.Units of Endocrinology and Diabetes, Department of MedicineUniversity Hospital Campus Bio MedicoRomeItaly
  3. 3.Endocrinology, Diabetes, and Metabolism UnitA.O. Ordine Mauriziano di Torino, “Umberto I” HospitalTurinItaly
  4. 4.Nuclear Medicine DepartmentGalliera HospitalGenoaItaly
  5. 5.Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional ImagingUniversity of MessinaMessinaItaly
  6. 6.Department of Medical and Surgical SciencesOspedale S. Andrea, Sapienza UniversityRomeItaly
  7. 7.Department of Traslational and Precision MedicineSapienza UniversityRomeItaly
  8. 8.Oncological Endocrinology UnitIRCCS—Regina Elena National Cancer InstituteRomeItaly
  9. 9.Unit of Endocrinology, Department of Clinical and Experimental Medicine, “G. Martino” University HospitalUniversity of MessinaMessinaItaly
  10. 10.Departments of Clinical and Molecular MedicineSapienza University, St. Andrea HospitalRomeItaly
  11. 11.Section of PathologyUniversity Hospital Campus Bio MedicoRomeItaly

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