Papillary thyroid carcinoma: ≤ 10 mm does not always mean pN0. A multicentric real-world study
The incidence of papillary thyroid carcinoma (PTC) is increasing and PTC ≤ 10 mm (PTMC) accounts for most new diagnoses. PTMCs are not always low risk, as detection of lymph nodes metastasis (LNM) may occur. The purpose of the study was to analyze the clinical pattern, frequency, and independent ris...
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| creator | Amendola, Stefano Piticchio, Tommaso Scappaticcio, Lorenzo Sellasie, Sium Wolde Volpe, Salvatore Le Moli, Rosario Coppola, Luigi Guidobaldi, Leo Pedicini, Francesco Carbone, Carla Caruso, Paola Gamarra, Elena Docimo, Giovanni Frasca, Francesco Uccioli, Luigi Trimboli, Pierpaolo |
| description | The incidence of papillary thyroid carcinoma (PTC) is increasing and PTC ≤ 10 mm (PTMC) accounts for most new diagnoses. PTMCs are not always low risk, as detection of lymph nodes metastasis (LNM) may occur. The purpose of the study was to analyze the clinical pattern, frequency, and independent risk factors of patients with PTMC and LNM. From January 2022 to June 2023, PTCs managed at CTO Hospital, Rome; Policlinico Vanvitelli, Naples; and Garibaldi Nesima Hospital, Catania were included. PTC management followed the same diagnostic–therapeutic procedures according to the ATA guidelines. Variables such as age, sex, maximum diameter, histologic evidence of LNM (HELNM +), Hashimoto’s thyroiditis (HT), multifocality, capsule invasion, and histological subtype were considered. PTCs were divided according to HELNM and size. Two hundred ninety-eight PTCs were included. PTMCs were 136 (45.6%) and LNM occurred in 27.2% of them. In the HELNM + group, analysis of PTMC vs ‘MacroPTC’ (PTC > 10 mm) did not show any statistical difference. Multivariate regression revealed that young age (OR 0.93; CI 95% 0.90–0.96;
p
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| doi_str_mv | 10.1007/s13304-024-01779-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11130044</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2938284289</sourcerecordid><originalsourceid>FETCH-LOGICAL-c398t-95c6a36629c513dc59a25cce67a45608e48e7993d08449234612b50988175e5c3</originalsourceid><addsrcrecordid>eNp9Uc0uBjEUbYQgeAEL6dJmaHs7ndZGRPwlggWJXVOdojIz_bQz5NvZegsLT-JRPInyfYSNJvf2Jvfc09N7EFqlZIMSUm0mCkB4QVgOWlWqEDNokRGQBQBls9OaAr1cQCsp3ZF8QH3mebQAknMBlVhE7syMfNOYOMb97TgGX2NrovVdaM3W-9Pz-_NrzpS8vbQtroNLuAs9Ns2jGSfcOtPh0QnZwDu4HZreW9f10VscnWmKxxCbGqd-qMfLaO7aNMmtTO8ldLG_d757WByfHhzt7hwXFpTsC1VaYUAIpmxJobalMqy01onK8FIQ6bh0lVJQk6xfMeCCsquSKClpVbrSwhLanvCOhqvW1V9yTKNH0bf5hzoYr_92On-rb8KDppQCIZxnhvUpQwz3g0u9bn2yLm-oc2FImimQTHImVYayCdTGkFJ01z_vUKI_PdITj3T2SH95pEUeWvut8Gfk25EMgAkg5VZ346K-C0Ps8tb-o_0AUXKftA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2938284289</pqid></control><display><type>article</type><title>Papillary thyroid carcinoma: ≤ 10 mm does not always mean pN0. A multicentric real-world study</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Amendola, Stefano ; Piticchio, Tommaso ; Scappaticcio, Lorenzo ; Sellasie, Sium Wolde ; Volpe, Salvatore ; Le Moli, Rosario ; Coppola, Luigi ; Guidobaldi, Leo ; Pedicini, Francesco ; Carbone, Carla ; Caruso, Paola ; Gamarra, Elena ; Docimo, Giovanni ; Frasca, Francesco ; Uccioli, Luigi ; Trimboli, Pierpaolo</creator><creatorcontrib>Amendola, Stefano ; Piticchio, Tommaso ; Scappaticcio, Lorenzo ; Sellasie, Sium Wolde ; Volpe, Salvatore ; Le Moli, Rosario ; Coppola, Luigi ; Guidobaldi, Leo ; Pedicini, Francesco ; Carbone, Carla ; Caruso, Paola ; Gamarra, Elena ; Docimo, Giovanni ; Frasca, Francesco ; Uccioli, Luigi ; Trimboli, Pierpaolo</creatorcontrib><description>The incidence of papillary thyroid carcinoma (PTC) is increasing and PTC ≤ 10 mm (PTMC) accounts for most new diagnoses. PTMCs are not always low risk, as detection of lymph nodes metastasis (LNM) may occur. The purpose of the study was to analyze the clinical pattern, frequency, and independent risk factors of patients with PTMC and LNM. From January 2022 to June 2023, PTCs managed at CTO Hospital, Rome; Policlinico Vanvitelli, Naples; and Garibaldi Nesima Hospital, Catania were included. PTC management followed the same diagnostic–therapeutic procedures according to the ATA guidelines. Variables such as age, sex, maximum diameter, histologic evidence of LNM (HELNM +), Hashimoto’s thyroiditis (HT), multifocality, capsule invasion, and histological subtype were considered. PTCs were divided according to HELNM and size. Two hundred ninety-eight PTCs were included. PTMCs were 136 (45.6%) and LNM occurred in 27.2% of them. In the HELNM + group, analysis of PTMC vs ‘MacroPTC’ (PTC > 10 mm) did not show any statistical difference. Multivariate regression revealed that young age (OR 0.93; CI 95% 0.90–0.96;
p
< 0.01) and male sex (male OR 3.44; CI 95% 1.16–10.20;
p
= 0.03) were the only independent risk factors for HELNM + in PTMC. The risk of LNM in PTMC is not negligible; therefore, a careful evaluation by an expert thyroidologist is mandatory for patients with small thyroid nodule, especially in younger and male patients before excluding surgery. In the future, new tools are needed to detect early PTMC with LNM before surgery.</description><identifier>ISSN: 2038-131X</identifier><identifier>ISSN: 2038-3312</identifier><identifier>EISSN: 2038-3312</identifier><identifier>DOI: 10.1007/s13304-024-01779-6</identifier><identifier>PMID: 38446376</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adult ; Age Factors ; Aged ; Female ; Humans ; Lymphatic Metastasis ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Staging ; Original ; Original Article ; Risk Factors ; Sex Factors ; Surgery ; Thyroid Cancer, Papillary - pathology ; Thyroid Cancer, Papillary - surgery ; Thyroid Neoplasms - diagnosis ; Thyroid Neoplasms - epidemiology ; Thyroid Neoplasms - pathology ; Thyroid Neoplasms - surgery</subject><ispartof>Updates in surgery, 2024-06, Vol.76 (3), p.1055-1061</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c398t-95c6a36629c513dc59a25cce67a45608e48e7993d08449234612b50988175e5c3</cites><orcidid>0000-0003-2972-9551</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s13304-024-01779-6$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s13304-024-01779-6$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38446376$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Amendola, Stefano</creatorcontrib><creatorcontrib>Piticchio, Tommaso</creatorcontrib><creatorcontrib>Scappaticcio, Lorenzo</creatorcontrib><creatorcontrib>Sellasie, Sium Wolde</creatorcontrib><creatorcontrib>Volpe, Salvatore</creatorcontrib><creatorcontrib>Le Moli, Rosario</creatorcontrib><creatorcontrib>Coppola, Luigi</creatorcontrib><creatorcontrib>Guidobaldi, Leo</creatorcontrib><creatorcontrib>Pedicini, Francesco</creatorcontrib><creatorcontrib>Carbone, Carla</creatorcontrib><creatorcontrib>Caruso, Paola</creatorcontrib><creatorcontrib>Gamarra, Elena</creatorcontrib><creatorcontrib>Docimo, Giovanni</creatorcontrib><creatorcontrib>Frasca, Francesco</creatorcontrib><creatorcontrib>Uccioli, Luigi</creatorcontrib><creatorcontrib>Trimboli, Pierpaolo</creatorcontrib><title>Papillary thyroid carcinoma: ≤ 10 mm does not always mean pN0. A multicentric real-world study</title><title>Updates in surgery</title><addtitle>Updates Surg</addtitle><addtitle>Updates Surg</addtitle><description>The incidence of papillary thyroid carcinoma (PTC) is increasing and PTC ≤ 10 mm (PTMC) accounts for most new diagnoses. PTMCs are not always low risk, as detection of lymph nodes metastasis (LNM) may occur. The purpose of the study was to analyze the clinical pattern, frequency, and independent risk factors of patients with PTMC and LNM. From January 2022 to June 2023, PTCs managed at CTO Hospital, Rome; Policlinico Vanvitelli, Naples; and Garibaldi Nesima Hospital, Catania were included. PTC management followed the same diagnostic–therapeutic procedures according to the ATA guidelines. Variables such as age, sex, maximum diameter, histologic evidence of LNM (HELNM +), Hashimoto’s thyroiditis (HT), multifocality, capsule invasion, and histological subtype were considered. PTCs were divided according to HELNM and size. Two hundred ninety-eight PTCs were included. PTMCs were 136 (45.6%) and LNM occurred in 27.2% of them. In the HELNM + group, analysis of PTMC vs ‘MacroPTC’ (PTC > 10 mm) did not show any statistical difference. Multivariate regression revealed that young age (OR 0.93; CI 95% 0.90–0.96;
p
< 0.01) and male sex (male OR 3.44; CI 95% 1.16–10.20;
p
= 0.03) were the only independent risk factors for HELNM + in PTMC. The risk of LNM in PTMC is not negligible; therefore, a careful evaluation by an expert thyroidologist is mandatory for patients with small thyroid nodule, especially in younger and male patients before excluding surgery. In the future, new tools are needed to detect early PTMC with LNM before surgery.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Female</subject><subject>Humans</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Original</subject><subject>Original Article</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>Surgery</subject><subject>Thyroid Cancer, Papillary - pathology</subject><subject>Thyroid Cancer, Papillary - surgery</subject><subject>Thyroid Neoplasms - diagnosis</subject><subject>Thyroid Neoplasms - epidemiology</subject><subject>Thyroid Neoplasms - pathology</subject><subject>Thyroid Neoplasms - surgery</subject><issn>2038-131X</issn><issn>2038-3312</issn><issn>2038-3312</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9Uc0uBjEUbYQgeAEL6dJmaHs7ndZGRPwlggWJXVOdojIz_bQz5NvZegsLT-JRPInyfYSNJvf2Jvfc09N7EFqlZIMSUm0mCkB4QVgOWlWqEDNokRGQBQBls9OaAr1cQCsp3ZF8QH3mebQAknMBlVhE7syMfNOYOMb97TgGX2NrovVdaM3W-9Pz-_NrzpS8vbQtroNLuAs9Ns2jGSfcOtPh0QnZwDu4HZreW9f10VscnWmKxxCbGqd-qMfLaO7aNMmtTO8ldLG_d757WByfHhzt7hwXFpTsC1VaYUAIpmxJobalMqy01onK8FIQ6bh0lVJQk6xfMeCCsquSKClpVbrSwhLanvCOhqvW1V9yTKNH0bf5hzoYr_92On-rb8KDppQCIZxnhvUpQwz3g0u9bn2yLm-oc2FImimQTHImVYayCdTGkFJ01z_vUKI_PdITj3T2SH95pEUeWvut8Gfk25EMgAkg5VZ346K-C0Ps8tb-o_0AUXKftA</recordid><startdate>20240601</startdate><enddate>20240601</enddate><creator>Amendola, Stefano</creator><creator>Piticchio, Tommaso</creator><creator>Scappaticcio, Lorenzo</creator><creator>Sellasie, Sium Wolde</creator><creator>Volpe, Salvatore</creator><creator>Le Moli, Rosario</creator><creator>Coppola, Luigi</creator><creator>Guidobaldi, Leo</creator><creator>Pedicini, Francesco</creator><creator>Carbone, Carla</creator><creator>Caruso, Paola</creator><creator>Gamarra, Elena</creator><creator>Docimo, Giovanni</creator><creator>Frasca, Francesco</creator><creator>Uccioli, Luigi</creator><creator>Trimboli, Pierpaolo</creator><general>Springer International Publishing</general><scope>C6C</scope><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>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2972-9551</orcidid></search><sort><creationdate>20240601</creationdate><title>Papillary thyroid carcinoma: ≤ 10 mm does not always mean pN0. A multicentric real-world study</title><author>Amendola, Stefano ; Piticchio, Tommaso ; Scappaticcio, Lorenzo ; Sellasie, Sium Wolde ; Volpe, Salvatore ; Le Moli, Rosario ; Coppola, Luigi ; Guidobaldi, Leo ; Pedicini, Francesco ; Carbone, Carla ; Caruso, Paola ; Gamarra, Elena ; Docimo, Giovanni ; Frasca, Francesco ; Uccioli, Luigi ; Trimboli, Pierpaolo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c398t-95c6a36629c513dc59a25cce67a45608e48e7993d08449234612b50988175e5c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Female</topic><topic>Humans</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Original</topic><topic>Original Article</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><topic>Surgery</topic><topic>Thyroid Cancer, Papillary - pathology</topic><topic>Thyroid Cancer, Papillary - surgery</topic><topic>Thyroid Neoplasms - diagnosis</topic><topic>Thyroid Neoplasms - epidemiology</topic><topic>Thyroid Neoplasms - pathology</topic><topic>Thyroid Neoplasms - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Amendola, Stefano</creatorcontrib><creatorcontrib>Piticchio, Tommaso</creatorcontrib><creatorcontrib>Scappaticcio, Lorenzo</creatorcontrib><creatorcontrib>Sellasie, Sium Wolde</creatorcontrib><creatorcontrib>Volpe, Salvatore</creatorcontrib><creatorcontrib>Le Moli, Rosario</creatorcontrib><creatorcontrib>Coppola, Luigi</creatorcontrib><creatorcontrib>Guidobaldi, Leo</creatorcontrib><creatorcontrib>Pedicini, Francesco</creatorcontrib><creatorcontrib>Carbone, Carla</creatorcontrib><creatorcontrib>Caruso, Paola</creatorcontrib><creatorcontrib>Gamarra, Elena</creatorcontrib><creatorcontrib>Docimo, Giovanni</creatorcontrib><creatorcontrib>Frasca, Francesco</creatorcontrib><creatorcontrib>Uccioli, Luigi</creatorcontrib><creatorcontrib>Trimboli, Pierpaolo</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Updates in surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Amendola, Stefano</au><au>Piticchio, Tommaso</au><au>Scappaticcio, Lorenzo</au><au>Sellasie, Sium Wolde</au><au>Volpe, Salvatore</au><au>Le Moli, Rosario</au><au>Coppola, Luigi</au><au>Guidobaldi, Leo</au><au>Pedicini, Francesco</au><au>Carbone, Carla</au><au>Caruso, Paola</au><au>Gamarra, Elena</au><au>Docimo, Giovanni</au><au>Frasca, Francesco</au><au>Uccioli, Luigi</au><au>Trimboli, Pierpaolo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Papillary thyroid carcinoma: ≤ 10 mm does not always mean pN0. A multicentric real-world study</atitle><jtitle>Updates in surgery</jtitle><stitle>Updates Surg</stitle><addtitle>Updates Surg</addtitle><date>2024-06-01</date><risdate>2024</risdate><volume>76</volume><issue>3</issue><spage>1055</spage><epage>1061</epage><pages>1055-1061</pages><issn>2038-131X</issn><issn>2038-3312</issn><eissn>2038-3312</eissn><abstract>The incidence of papillary thyroid carcinoma (PTC) is increasing and PTC ≤ 10 mm (PTMC) accounts for most new diagnoses. PTMCs are not always low risk, as detection of lymph nodes metastasis (LNM) may occur. The purpose of the study was to analyze the clinical pattern, frequency, and independent risk factors of patients with PTMC and LNM. From January 2022 to June 2023, PTCs managed at CTO Hospital, Rome; Policlinico Vanvitelli, Naples; and Garibaldi Nesima Hospital, Catania were included. PTC management followed the same diagnostic–therapeutic procedures according to the ATA guidelines. Variables such as age, sex, maximum diameter, histologic evidence of LNM (HELNM +), Hashimoto’s thyroiditis (HT), multifocality, capsule invasion, and histological subtype were considered. PTCs were divided according to HELNM and size. Two hundred ninety-eight PTCs were included. PTMCs were 136 (45.6%) and LNM occurred in 27.2% of them. In the HELNM + group, analysis of PTMC vs ‘MacroPTC’ (PTC > 10 mm) did not show any statistical difference. Multivariate regression revealed that young age (OR 0.93; CI 95% 0.90–0.96;
p
< 0.01) and male sex (male OR 3.44; CI 95% 1.16–10.20;
p
= 0.03) were the only independent risk factors for HELNM + in PTMC. The risk of LNM in PTMC is not negligible; therefore, a careful evaluation by an expert thyroidologist is mandatory for patients with small thyroid nodule, especially in younger and male patients before excluding surgery. In the future, new tools are needed to detect early PTMC with LNM before surgery.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>38446376</pmid><doi>10.1007/s13304-024-01779-6</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-2972-9551</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Age Factors Aged Female Humans Lymphatic Metastasis Male Medicine Medicine & Public Health Middle Aged Neoplasm Staging Original Original Article Risk Factors Sex Factors Surgery Thyroid Cancer, Papillary - pathology Thyroid Cancer, Papillary - surgery Thyroid Neoplasms - diagnosis Thyroid Neoplasms - epidemiology Thyroid Neoplasms - pathology Thyroid Neoplasms - surgery |
| title | Papillary thyroid carcinoma: ≤ 10 mm does not always mean pN0. A multicentric real-world study |
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