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Impact of expert review of histological diagnosis of papillary and follicular thyroid cancer

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Abstract

Purpose

Histologic and pTNM classification of differentiated thyroid cancer (DTC) is mandatory to assess risk of relapse, risk of death, and radioactive iodine administration. The impact of an expert central review of external pathology reports has not yet been reported.

Methods

Monocentric retrospective study to evaluate the difference between initial and second-opinion histopathologic diagnosis for DTC patients referred for post-operative radioactive iodine administration between January 2014 and December 2016. We evaluated major discordance (change of diagnosis from malignant to benign or in main histological subtype or a description of aggressive pathological subtypes), minor discordance (change in histological subtype or description of an aggressive component, multifocality or extrathyroidal extension), and change in ATA classification.

Results

A second-opinion histological diagnosis was available for 199 patients. A major discordance was observed in 42 (21%) cases (changes in malignancy in 4 cases, changes in main histological subtype in 22, changes in aggressive pathology variants of PTC in 16). One hundred and four minor discordances were observed regarding 92 patients. These histopathological changes led to changes in the ATA 2015 risk stratification classification in 61 (31%) of cases. There were no predictive factors of major/minor histologic changes or ATA risk stratification changes.

Conclusion

Expert central review of pathology has an impact on the 2015 ATA risk stratification classification that can lead to changes in the management of patients with differentiated thyroid cancer.

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Acknowledgements

We acknowledge Aurelie Bernard and Dr. Emmanuelle Kuhn for their help in the data collection.

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Author notes

  1. These authors contributed equally: Abir Al Ghuzlan, Sophie Leboulleux

Authors and Affiliations

  1. Department of Endocrine Oncology and Nuclear Medicine, Gustave Roussy and Paris Saclay University, 114 Rue Edouard Vaillant, 94805, Villejuif, France

    Segolene Hescot, Julien Hadoux, Marie Terroir, Eric Baudin, Martin Schlumberger & Sophie Leboulleux

  2. Department of Endocrine Oncology and Nuclear Medicine, Institut Curie, 35 rue Dailly, 92220, Saint-Cloud, France

    Segolene Hescot

  3. Department of Pathology, Gustave Roussy and Paris Saclay University, 114 Rue Edouard Vaillant, 94805, Villejuif, France

    Hala Sheikh-Alard, Manal Kordahi, Jean-Yves Scoazec & Abir Al Ghuzlan

  4. Department of Surgery, Gustave Roussy and Paris Saclay University, 114 Rue Edouard Vaillant, 94805, Villejuif, France

    Dana Hartl & Ingrid Breuskin

Authors
  1. Segolene Hescot
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  2. Hala Sheikh-Alard
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  3. Manal Kordahi
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  4. Dana Hartl
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  5. Julien Hadoux
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  6. Marie Terroir
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  7. Ingrid Breuskin
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  8. Eric Baudin
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  9. Jean-Yves Scoazec
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  10. Martin Schlumberger
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  11. Abir Al Ghuzlan
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  12. Sophie Leboulleux
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Contributions

S.H., A.A.G., S.L.: Conception and Design; Analysis and Interpretation of data. S.H., H.A.S., M.K., A.A.G.: Acquisition of data. S.H., S.L.: Paper Writing. All authors: Paper Revision and Final Approval

Corresponding author

Correspondence to Segolene Hescot.

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The authors declare that they have no conflict of interest.

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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. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Hescot, S., Sheikh-Alard, H., Kordahi, M. et al. Impact of expert review of histological diagnosis of papillary and follicular thyroid cancer. Endocrine 72, 791–797 (2021). https://doi.org/10.1007/s12020-020-02531-x

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  • DOI: https://doi.org/10.1007/s12020-020-02531-x

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