Non invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFT-P). A clinic evaluation of novel nomenclature
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Abstract
AIM: We aimed to find out unnecessarily overdiagnosed and overtreated patients, their preventable morbidities, expenditures which might not have occurred in the last decade concerning newly proposed nomenclature MATERIAL AND METHODS: Among 1553 patients operated between 2010-2019, 197 were recorded. Pathology specimens were re-evaluated by two experienced pathologists to reveal those patients who could have diagnosed as NIFT-P.
RESULTS: According to the changes first suggested by Nikiforov in 2016 and partially revised in 2018; 55 of 197 patients were diagnosed with NIFT-P. Four (7.2%) patients had NIFT-P (operated after 2016), 14 patients (25.5%) had follicular adenoma, 13 patients (23.6%) had unknown malign potential, five patients (9.1%) had papillary microcarcinoma, two patients (3.6%) had papillary microcarcinoma encapsulated, five patients (9.1%) had papillary carcinoma follicular and two patients (3.6%) had papillary carcinoma encapsulated. 40 patients (72.7%) underwent thyroidectomy (bilateral total), 12 patients (21.8%) thyroidectomy (lobectomy, unilateral), two patients (3.6%) thyroidectomy (completion, total) and one patient (1.8%) neck dissection + thyroidectomy (bilateral, total).
DISCUSSION: The follicular variant of the papillary thyroid carcinoma was re-defined with a novel nomenclature as a noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFT-P) according to its indolent behavior that did not require aggressive treatment,so lobectomy is sufficient, was suggested in 2016.
CONCLUSIONS: We found out that if we hadn’t applied thyroidectomy (total or completion) to those 43 patients concerning new nomenclature, we could have prevented complications (2 patients, %3,6) and cut down the expenses caused by overtreatment in the last decade. NIFT-P has an excellent prognosis for its low locoregional or distant recurrence, so lobectomy is sufficient.