Noninvasive Encapsulated Follicular Variant of Papillary Thyroid Cancer: Clinical Lessons from a Community-Based Endocrine Surgical Practice.
Allan GoldingDana ShivelyDavid N BimstonR Mack HarrellPublished in: International journal of surgical oncology (2017)
Objective. Retrospective studies have found that noninvasive encapsulated follicular variant of papillary thyroid cancer (EFVPTC) exhibits highly indolent clinical behavior. We studied the clinical features of our patients with noninvasive EFVPTC tumors culled from a community endocrine surgical practice registry over the past four years. Methods. We interrogated the Memorial Center for Integrative Endocrine Surgery (MCIES) Registry for all recorded encapsulated follicular variant of papillary cancer pathologic diagnoses. We identified a subgroup of patients without capsular or vascular invasion and studied their clinical characteristics. Results. Thirty-seven patients met inclusion and exclusion criteria. The typical patient was young and female. Nodules averaged 3.1 cm in greatest dimension by ultrasound evaluation. Thirteen patients were found to have synchronous malignancies elsewhere in the thyroid (35%). At the time of this writing, we have not seen a clinical recurrence in any of our 37 noninvasive EFVPTC patients. Conclusions. Early clinical follow-up data suggests that the majority of noninvasive EFVPTC tumors exhibit indolent behavior, but clinical decision-making with regard to completion thyroidectomy, central lymph node dissection, and adjunctive radioiodine therapy often depends on the amount and type of synchronous thyroid cancer detected elsewhere in the thyroid gland and the central neck.
Keyphrases
- papillary thyroid
- end stage renal disease
- ejection fraction
- newly diagnosed
- chronic kidney disease
- healthcare
- lymph node metastasis
- prognostic factors
- clinical trial
- magnetic resonance imaging
- peritoneal dialysis
- minimally invasive
- decision making
- coronary artery disease
- computed tomography
- randomized controlled trial
- radiation therapy
- acute coronary syndrome
- mental health
- machine learning
- case report
- bone marrow
- squamous cell
- patient reported
- ultrasound guided
- robot assisted
- early stage
- hodgkin lymphoma
- double blind
- placebo controlled