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Kaliszewski K, Diakowska D, Miciak M, Jurkiewicz K, Kisiel M, Makles S, Dziekiewicz A, Biernat S, Ludwig M, Ludwig B, Sutkowska-Stępień K, Sebastian M, Domosławski P, Sutkowski K, Wojtczak B. The Incidence Trend and Management of Thyroid Cancer-What Has Changed in the Past Years: Own Experience and Literature Review. Cancers (Basel) 2023; 15:4941. [PMID: 37894308 PMCID: PMC10605595 DOI: 10.3390/cancers15204941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 09/30/2023] [Accepted: 10/08/2023] [Indexed: 10/29/2023] Open
Abstract
Because of ambiguous and widely debated observations concerning the incidence, trend, and management of TC, we performed this analysis. We drew attention to some events, such as "cancer screening activity", introduction of noninvasive follicular neoplasm with papillary-like nuclear features (NIFTP) to TC types, possibility of papillary thyroid microcarcinoma (PTMC) active surveillance (AS), occurrence of personalized medicine in TC management, and, finally, COVID-19 pandemic time. Because of the opinion that all changes have been made mostly by PTC, we compared it to the remaining types of TC in terms of incidence, clinical and pathological characteristics, and treatment. We analyzed patients treated in a single surgical center in eastern Europe (Poland). The prevalence of TC significantly increased from 5.15% in 2008 to 13.84% in 2015, and then significantly decreased to 1.33% in 2022 when the COVID-19 pandemic lasted (p < 0.0001). A similar trend was observed for PTC, when the incidence significantly increased to 13.99% in 2015 and then decreased to 1.38% in 2022 (p < 0.0001). At that time, the NIFTP category was introduced, and observation of PTMC began. The prevalence of FTC and MTC also increased until 2015 and then decreased. Significant differences in age, types of surgery, necessity of reoperation, and pTNM between PTCs and other types of TCs were observed. The average age was significantly lower in PTC patients than in patients with the remaining types of TC (p < 0.0001). Four milestones, including NIFTP introduction, the possibility of PTMC AS, personalized cancer medicine, and the COVID-19 pandemic, may have influenced the general statistics of TC.
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Affiliation(s)
- Krzysztof Kaliszewski
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.M.); (K.J.); (M.K.); (S.M.); (A.D.); (S.B.); (B.L.); (K.S.-S.); (M.S.); (P.D.); (K.S.); (B.W.)
| | - Dorota Diakowska
- Department of Basic Sciences, Faculty of Health Science, Wroclaw Medical University, 50-367 Wrocław, Poland;
| | - Michał Miciak
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.M.); (K.J.); (M.K.); (S.M.); (A.D.); (S.B.); (B.L.); (K.S.-S.); (M.S.); (P.D.); (K.S.); (B.W.)
| | - Krzysztof Jurkiewicz
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.M.); (K.J.); (M.K.); (S.M.); (A.D.); (S.B.); (B.L.); (K.S.-S.); (M.S.); (P.D.); (K.S.); (B.W.)
| | - Michał Kisiel
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.M.); (K.J.); (M.K.); (S.M.); (A.D.); (S.B.); (B.L.); (K.S.-S.); (M.S.); (P.D.); (K.S.); (B.W.)
| | - Szymon Makles
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.M.); (K.J.); (M.K.); (S.M.); (A.D.); (S.B.); (B.L.); (K.S.-S.); (M.S.); (P.D.); (K.S.); (B.W.)
| | - Anna Dziekiewicz
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.M.); (K.J.); (M.K.); (S.M.); (A.D.); (S.B.); (B.L.); (K.S.-S.); (M.S.); (P.D.); (K.S.); (B.W.)
| | - Szymon Biernat
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.M.); (K.J.); (M.K.); (S.M.); (A.D.); (S.B.); (B.L.); (K.S.-S.); (M.S.); (P.D.); (K.S.); (B.W.)
| | - Maksymilian Ludwig
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.M.); (K.J.); (M.K.); (S.M.); (A.D.); (S.B.); (B.L.); (K.S.-S.); (M.S.); (P.D.); (K.S.); (B.W.)
| | - Bartłomiej Ludwig
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.M.); (K.J.); (M.K.); (S.M.); (A.D.); (S.B.); (B.L.); (K.S.-S.); (M.S.); (P.D.); (K.S.); (B.W.)
| | - Karolina Sutkowska-Stępień
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.M.); (K.J.); (M.K.); (S.M.); (A.D.); (S.B.); (B.L.); (K.S.-S.); (M.S.); (P.D.); (K.S.); (B.W.)
| | - Maciej Sebastian
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.M.); (K.J.); (M.K.); (S.M.); (A.D.); (S.B.); (B.L.); (K.S.-S.); (M.S.); (P.D.); (K.S.); (B.W.)
| | - Paweł Domosławski
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.M.); (K.J.); (M.K.); (S.M.); (A.D.); (S.B.); (B.L.); (K.S.-S.); (M.S.); (P.D.); (K.S.); (B.W.)
| | - Krzysztof Sutkowski
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.M.); (K.J.); (M.K.); (S.M.); (A.D.); (S.B.); (B.L.); (K.S.-S.); (M.S.); (P.D.); (K.S.); (B.W.)
| | - Beata Wojtczak
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, 50-367 Wrocław, Poland; (M.M.); (K.J.); (M.K.); (S.M.); (A.D.); (S.B.); (B.L.); (K.S.-S.); (M.S.); (P.D.); (K.S.); (B.W.)
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Clinical-pathological issues in thyroid pathology: study on the routine application of NIFTP diagnostic criteria. Sci Rep 2019; 9:13179. [PMID: 31515532 PMCID: PMC6742662 DOI: 10.1038/s41598-019-49851-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 09/02/2019] [Indexed: 02/08/2023] Open
Abstract
In 2017, the WHO classification of tumours of the endocrine organs established the criteria for a NIFTP diagnosis. The present paper considers some aspects that are still debated or unresolved: the real incidence and clinical meaning of multifocal/multinodular lesions, the biological behaviour of micro-NIFTP, the sprinkling phenomenon and the corresponding modifications to the FNA reporting systems based on changes to the ROM. Moreover, the paper suggests possible scenarios for the clinical-pathological management of this entity. From the initial 1470 cases, a group of 68 NIFTPs was recruited in a 9 year-long period. The average age at diagnosis was 55 years. The average diameter of the lesion was 1.7 cm (0.1 cm–10 cm). In 41 cases (60.1%), the lesion was inserted in the context of a multinodular background. In 12 cases, the diagnosis was incidental and the pre- operative FNA was performed on a different target. In 10 out of 68 cases, there was a multifocal NIFTP; in 14.7% of patients, PTC-like nuclear features showed sprinkling phenomenon. The cytological revision allocated 21 cases (49%) to the SIAPEC TIR3 indeterminate class and a nuclear score 2 or 3 were identified in 25 smears. Multifocality is part of the spectrum of NIFTPs, that can arise in a multinodular background with variable sizes from microscopic lesions to very large ones. Cytopathological criteria such as an evaluation of the nuclear score may help the pathologists in promoting a NIFTP diagnosis in the preoperative setting.
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