How to identify indolent thyroid tumors unlikely to recur and cause cancer death immediately after surgery—Risk stratification of papillary thyroid carcinoma in young patients
Current histopathological diagnosis methods cannot distinguish the two types of thyroid carcinoma: clinically significant carcinomas with a potential risk of recurrence, metastasis, and cancer death, and clinically insignificant carcinomas with a slow growth rate. Both thyroid tumors are diagnosed a...
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| Veröffentlicht in: | ENDOCRINE JOURNAL 2021, Vol.68(8), pp.871-880 |
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| creator | Kakudo, Kennichi Liu, Zhiyan Bai, Yanhua Li, Yaqiong Kitayama, Naomi Satoh, Shinya Nakashima, Masahiro Jung, Chan Kwon |
| description | Current histopathological diagnosis methods cannot distinguish the two types of thyroid carcinoma: clinically significant carcinomas with a potential risk of recurrence, metastasis, and cancer death, and clinically insignificant carcinomas with a slow growth rate. Both thyroid tumors are diagnosed as “carcinoma” in current pathology practice. The clinician usually recommends surgery to the patient and the patient often accepts it because of cancer terminology. The treatment for these clinically insignificant carcinomas does not benefit the patient and negatively impacts society. The author proposed risk stratification of thyroid tumors using the growth rate (Ki-67 labeling index), which accurately differentiates four prognostically relevant risk groups based on the Ki-67 labeling index, ≥30%, ≥10 and 5 and |
| doi_str_mv | 10.1507/endocrj.EJ21-0018 |
| format | Article |
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Both thyroid tumors are diagnosed as “carcinoma” in current pathology practice. The clinician usually recommends surgery to the patient and the patient often accepts it because of cancer terminology. The treatment for these clinically insignificant carcinomas does not benefit the patient and negatively impacts society. The author proposed risk stratification of thyroid tumors using the growth rate (Ki-67 labeling index), which accurately differentiates four prognostically relevant risk groups based on the Ki-67 labeling index, ≥30%, ≥10 and <30%, >5 and <10%, and ≤5%. Indolent thyroid tumors with an excellent prognosis have the following four features: young age, early-stage (T1-2 M0), curatively treated, and low proliferation index (Ki-67 labeling index of ≤5%), and are unlikely to recur, metastasize, or cause cancer death. Accurate identification of these indolent tumors helps clinicians select more conservative treatments to avoid unnecessary aggressive (total thyroidectomy followed by radio-active iodine) treatments. Clinicians can alleviate the fears of patients by confirming these four features, including the low proliferation rate, in a pathology report immediately after surgery when patients are most concerned.</description><identifier>ISSN: 0918-8959</identifier><identifier>EISSN: 1348-4540</identifier><identifier>DOI: 10.1507/endocrj.EJ21-0018</identifier><identifier>PMID: 33980775</identifier><language>eng</language><publisher>Japan: The Japan Endocrine Society</publisher><subject>Adult ; Death ; Female ; Growth rate ; Humans ; Iodine ; Ki-67 ; Labeling ; Male ; Metastases ; Middle Aged ; Papillary thyroid carcinoma ; Patient anxiety ; Patients ; Prognosis ; Risk Assessment ; Risk groups ; Surgery ; Thyroid ; Thyroid cancer ; Thyroid Cancer, Papillary - pathology ; Thyroid Cancer, Papillary - surgery ; Thyroid carcinoma ; Thyroid Gland - pathology ; Thyroid Gland - surgery ; Thyroid Neoplasms - pathology ; Thyroid Neoplasms - surgery ; Thyroidectomy ; Tumors</subject><ispartof>Endocrine Journal, 2021, Vol.68(8), pp.871-880</ispartof><rights>The Japan Endocrine Society</rights><rights>Copyright Japan Science and Technology Agency 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c691t-cb1da5746ab3dcf6022970617f0fdb3abcbc1879f2548373f79056d6ade12a523</citedby><cites>FETCH-LOGICAL-c691t-cb1da5746ab3dcf6022970617f0fdb3abcbc1879f2548373f79056d6ade12a523</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1883,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33980775$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kakudo, Kennichi</creatorcontrib><creatorcontrib>Liu, Zhiyan</creatorcontrib><creatorcontrib>Bai, Yanhua</creatorcontrib><creatorcontrib>Li, Yaqiong</creatorcontrib><creatorcontrib>Kitayama, Naomi</creatorcontrib><creatorcontrib>Satoh, Shinya</creatorcontrib><creatorcontrib>Nakashima, Masahiro</creatorcontrib><creatorcontrib>Jung, Chan Kwon</creatorcontrib><creatorcontrib>Shanghai Sixth People's Hospital Affiliated with Shanghai Jiao Tong University School of Medicine</creatorcontrib><creatorcontrib>Nagasaki University</creatorcontrib><creatorcontrib>Kyoto University Graduate School of Medicine</creatorcontrib><creatorcontrib>Yamashita Thyroid Hospital</creatorcontrib><creatorcontrib>College of Medicine</creatorcontrib><creatorcontrib>Department of Pathology</creatorcontrib><creatorcontrib>Department of Tumor and Diagnostic Pathology</creatorcontrib><creatorcontrib>The Catholic University of Korea</creatorcontrib><creatorcontrib>Department of Hospital Pathology</creatorcontrib><creatorcontrib>Cancer Genome Center and Thyroid Disease Center</creatorcontrib><creatorcontrib>Peking University Cancer Hospital & Institute</creatorcontrib><creatorcontrib>Department of Endocrine Surgery</creatorcontrib><creatorcontrib>Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education</creatorcontrib><creatorcontrib>Izumi City General Hospital</creatorcontrib><creatorcontrib>Department of Dermatology</creatorcontrib><creatorcontrib>Shandong Provincial Hospital Affiliated with Shandong First Medical University</creatorcontrib><creatorcontrib>Atomic Bomb Disease Institute</creatorcontrib><title>How to identify indolent thyroid tumors unlikely to recur and cause cancer death immediately after surgery—Risk stratification of papillary thyroid carcinoma in young patients</title><title>ENDOCRINE JOURNAL</title><addtitle>Endocr J</addtitle><description>Current histopathological diagnosis methods cannot distinguish the two types of thyroid carcinoma: clinically significant carcinomas with a potential risk of recurrence, metastasis, and cancer death, and clinically insignificant carcinomas with a slow growth rate. Both thyroid tumors are diagnosed as “carcinoma” in current pathology practice. The clinician usually recommends surgery to the patient and the patient often accepts it because of cancer terminology. The treatment for these clinically insignificant carcinomas does not benefit the patient and negatively impacts society. The author proposed risk stratification of thyroid tumors using the growth rate (Ki-67 labeling index), which accurately differentiates four prognostically relevant risk groups based on the Ki-67 labeling index, ≥30%, ≥10 and <30%, >5 and <10%, and ≤5%. Indolent thyroid tumors with an excellent prognosis have the following four features: young age, early-stage (T1-2 M0), curatively treated, and low proliferation index (Ki-67 labeling index of ≤5%), and are unlikely to recur, metastasize, or cause cancer death. Accurate identification of these indolent tumors helps clinicians select more conservative treatments to avoid unnecessary aggressive (total thyroidectomy followed by radio-active iodine) treatments. Clinicians can alleviate the fears of patients by confirming these four features, including the low proliferation rate, in a pathology report immediately after surgery when patients are most concerned.</description><subject>Adult</subject><subject>Death</subject><subject>Female</subject><subject>Growth rate</subject><subject>Humans</subject><subject>Iodine</subject><subject>Ki-67</subject><subject>Labeling</subject><subject>Male</subject><subject>Metastases</subject><subject>Middle Aged</subject><subject>Papillary thyroid carcinoma</subject><subject>Patient anxiety</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Risk Assessment</subject><subject>Risk groups</subject><subject>Surgery</subject><subject>Thyroid</subject><subject>Thyroid cancer</subject><subject>Thyroid Cancer, Papillary - pathology</subject><subject>Thyroid Cancer, Papillary - surgery</subject><subject>Thyroid carcinoma</subject><subject>Thyroid Gland - pathology</subject><subject>Thyroid Gland - surgery</subject><subject>Thyroid Neoplasms - pathology</subject><subject>Thyroid Neoplasms - surgery</subject><subject>Thyroidectomy</subject><subject>Tumors</subject><issn>0918-8959</issn><issn>1348-4540</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkc1u1DAUhSMEokPhAdggS2zYpPgnsZ0lqkoLqoSEYG05tjPjaWJP_SOUHQ_Bi_BKPAlOZ0glNteW9fncc--pqtcIXqAWsvfGaa_C_uLqM0Y1hIg_qTaINLxu2gY-rTawQ7zmXdudVS9i3ENISNuQ59UZIR2HjLWb6veN_wGSB1Ybl-wwA1s0x3IHaTcHbzVIefIhguxGe2fGeYGDUTkA6TRQMkdTqlMmAG1k2gE7TUZbmRZWDqm8xxy2Jsx_fv76auMdiCnI0sqqUr0DfgAHebDjKMO8NlUyKOv8JIsfMPvstgVKtviKL6tngxyjeXU6z6vvH6--Xd7Ut1-uP11-uK0V7VCqVY-0bFlDZU-0GijEuGOQIjbAQfdE9qpXiLNuwG3DCSMD62BLNZXaICxbTM6rd0fdQ_D32cQkJhuVKT6d8TkK3GJKICYYFvTtf-je5-CKu0JRTmDTIF4odKRU8DEGM4hDsFOZWiAoljzFKU-x5CmWPMufNyfl3Je1rj_-BViA6yOwLF3J0ZeYnHnsr-7pg6rA8EGTcsgXaQE5WwqHhDNaxn1U2sckt2ZtJUOyajSrOcoFX8pqciXUToaCkb9xjNNV</recordid><startdate>20210101</startdate><enddate>20210101</enddate><creator>Kakudo, Kennichi</creator><creator>Liu, Zhiyan</creator><creator>Bai, Yanhua</creator><creator>Li, Yaqiong</creator><creator>Kitayama, Naomi</creator><creator>Satoh, Shinya</creator><creator>Nakashima, Masahiro</creator><creator>Jung, Chan Kwon</creator><general>The Japan Endocrine Society</general><general>Japan Science and Technology Agency</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>20210101</creationdate><title>How to identify indolent thyroid tumors unlikely to recur and cause cancer death immediately after surgery—Risk stratification of papillary thyroid carcinoma in young patients</title><author>Kakudo, Kennichi ; Liu, Zhiyan ; Bai, Yanhua ; Li, Yaqiong ; Kitayama, Naomi ; Satoh, Shinya ; Nakashima, Masahiro ; Jung, Chan Kwon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c691t-cb1da5746ab3dcf6022970617f0fdb3abcbc1879f2548373f79056d6ade12a523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Death</topic><topic>Female</topic><topic>Growth rate</topic><topic>Humans</topic><topic>Iodine</topic><topic>Ki-67</topic><topic>Labeling</topic><topic>Male</topic><topic>Metastases</topic><topic>Middle Aged</topic><topic>Papillary thyroid carcinoma</topic><topic>Patient anxiety</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Risk Assessment</topic><topic>Risk groups</topic><topic>Surgery</topic><topic>Thyroid</topic><topic>Thyroid cancer</topic><topic>Thyroid Cancer, Papillary - 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Both thyroid tumors are diagnosed as “carcinoma” in current pathology practice. The clinician usually recommends surgery to the patient and the patient often accepts it because of cancer terminology. The treatment for these clinically insignificant carcinomas does not benefit the patient and negatively impacts society. The author proposed risk stratification of thyroid tumors using the growth rate (Ki-67 labeling index), which accurately differentiates four prognostically relevant risk groups based on the Ki-67 labeling index, ≥30%, ≥10 and <30%, >5 and <10%, and ≤5%. Indolent thyroid tumors with an excellent prognosis have the following four features: young age, early-stage (T1-2 M0), curatively treated, and low proliferation index (Ki-67 labeling index of ≤5%), and are unlikely to recur, metastasize, or cause cancer death. Accurate identification of these indolent tumors helps clinicians select more conservative treatments to avoid unnecessary aggressive (total thyroidectomy followed by radio-active iodine) treatments. Clinicians can alleviate the fears of patients by confirming these four features, including the low proliferation rate, in a pathology report immediately after surgery when patients are most concerned.</abstract><cop>Japan</cop><pub>The Japan Endocrine Society</pub><pmid>33980775</pmid><doi>10.1507/endocrj.EJ21-0018</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Endocrine Journal, 2021, Vol.68(8), pp.871-880 |
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| subjects | Adult Death Female Growth rate Humans Iodine Ki-67 Labeling Male Metastases Middle Aged Papillary thyroid carcinoma Patient anxiety Patients Prognosis Risk Assessment Risk groups Surgery Thyroid Thyroid cancer Thyroid Cancer, Papillary - pathology Thyroid Cancer, Papillary - surgery Thyroid carcinoma Thyroid Gland - pathology Thyroid Gland - surgery Thyroid Neoplasms - pathology Thyroid Neoplasms - surgery Thyroidectomy Tumors |
| title | How to identify indolent thyroid tumors unlikely to recur and cause cancer death immediately after surgery—Risk stratification of papillary thyroid carcinoma in young patients |
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