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Graphical abstract
Abstract
Background
Thyroid carcinoma (TC) incidence increased over the past 50 years. The explanation for this is not consensual.
Objective
Compare incidental vs non-incidental TC (ITC vs NITC) regarding demographic, clinical, histological data and 5-year clinical outcomes.
Design
Retrospective analysis of 225 papillary TC (PTC) cases that completed a 5-year follow-up.
Methods
Created 2 groups: ITC (including the incidentalomas) and NITC (cases of palpable or visible nodules or with thyroid compressive complaints).
Results
Included 225 PTC (122 were ITC). There were 95 women in ITC and 78 in NITC. ITC patients were significantly older (53.3 ± 14.8 vs 47.2 ± 17.7, P = 0.006). Groups had no differences in family history of TC. ITC mean tumour size was smaller (19.1 ± 9.2 vs 28.6 ± 16.2, P < 0.01). Tumours > 20 mm comprised 36.1% of ITC and 58.2% of NITC. We found no differences in tumour multifocality, histological thyroiditis, aggressive PTC subtypes, capsule or lymph-vascular invasion and gross extrathyroidal extension. There were no differences regarding the number of patients submitted to RAI or in RAI activity. pTMN staging showed higher prevalence of T3a and T4 cases (P < 0.01), and M1 status (P = 0.025) in NITC. There were no differences in the rates of persistence of disease. Logistic regression showed that the diagnostic modality had no impact on the 5-year clinical outcome.
Conclusion
ITC patients were older and had smaller tumours. NITC showed no worst histological features or 5-year clinical outcome. Approximately, one third of ITC had diameters > 20 mm. As even large tumours can be ITC, overdiagnosis is the most likely cause of increasing incidence of TC.
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metastatic disease, where QoL issues are more likely to be manifest and assessed. If the QaLM study had shown a clear preference for any of the QoL tools, it was anticipated that this would then have been promoted in the thyroid oncology community as the
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Nova Medical School, Lisbon, Portugal
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Nova Medical School, Lisbon, Portugal
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% reduction in tumor burden after 2 months was reported. However, after 6 months, disease progressed. The use of lenvatinib has been approved for ATC treatment in Japan. However, a phase 2 trial of lenvatinib in ATC, through the International Thyroid
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metastases. This is in agreement with the oncogenic addiction concept in thyroid oncology. DNA- and RNA-based NGS performed on the fine needle aspirate was uninterpretable for 7 out of 34 samples (21%) and 6 out of 32 samples (19%), respectively. One limit
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clinicians committed in their practice to thyroid oncology, is needed to provide more accurate results on the perceived role of MIT in that specific field. A strength of this survey is that respondents were from European countries, albeit we acknowledge
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Department of Medicine, University of Alcalá de Henares, Madrid
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IdiSNA (Instituto de investigación en la salud de Navarra), Pamplona, Spain
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tandem model. The dual role (diagnostic and therapeutic or theranostics) of such molecular imaging techniques will expand the contribution of this to thyroid oncology. Current positron emission tomography (PET) modalities are designed to visualize
