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

Richa Singh, Jorge Avila, Kahee Jo, Kevin T.K. Nguyen, Nika Roa Carrillo, Eric C Huang, Michael Campbell

Research output: Contribution to journalArticle

11 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalAnnals of Surgical Oncology
DOIs
StateAccepted/In press - Aug 11 2017

Fingerprint

Thyroid Neoplasms
Cell Biology
Fine Needle Biopsy
Thyroidectomy
Neoplasms
Surgical Pathology
Factor IX
Tertiary Care Centers
Thyroid Gland
Odds Ratio
Papillary Thyroid cancer
Confidence Intervals
Pathology

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Patients with Non-invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features are Unlikely to have Malignant Preoperative Cytology. / Singh, Richa; Avila, Jorge; Jo, Kahee; Nguyen, Kevin T.K.; Carrillo, Nika Roa; Huang, Eric C; Campbell, Michael.

In: Annals of Surgical Oncology, 11.08.2017, p. 1-6.

Research output: Contribution to journalArticle

@article{a26a3391527947bb81d18557daf5b3be,
title = "Patients with Non-invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features are Unlikely to have Malignant Preoperative Cytology",
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.",
author = "Richa Singh and Jorge Avila and Kahee Jo and Nguyen, {Kevin T.K.} and Carrillo, {Nika Roa} and Huang, {Eric C} and Michael Campbell",
year = "2017",
month = "8",
day = "11",
doi = "10.1245/s10434-017-6038-5",
language = "English (US)",
pages = "1--6",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York",

}

TY - JOUR

T1 - Patients with Non-invasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features are Unlikely to have Malignant Preoperative Cytology

AU - Singh, Richa

AU - Avila, Jorge

AU - Jo, Kahee

AU - Nguyen, Kevin T.K.

AU - Carrillo, Nika Roa

AU - Huang, Eric C

AU - Campbell, Michael

PY - 2017/8/11

Y1 - 2017/8/11

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=85027385599&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85027385599&partnerID=8YFLogxK

U2 - 10.1245/s10434-017-6038-5

DO - 10.1245/s10434-017-6038-5

M3 - Article

C2 - 28801882

AN - SCOPUS:85027385599

SP - 1

EP - 6

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

ER -