Mehmet Refik GÖKTUĞ, Özen ÖZ GÜL, Soner CANDER

Retrospective evaluation of radioactive iodine ablation therapy in the Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features (NIFTP) and Thyroid tumors with uncertain malignity potential

Background: Noninvasive Follicular Thyroid Neoplasm (NIFTP), Well differantiated thyroid tumor with uncertain malignity potential (WDT-UMP), follicular thyroid tumor with uncertain malignity potential (FT-UMP), and Hurtle cell neoplasia with uncertain malignity potential (HCN-UMP) have been included in the classification of thyroid tumors by WHO, with the incidence of thyroid cancer increasing every passing year. There is no consensus regarding the follow-up and treatment processes of these tumors. Our study aims to shed light on our clinical practice by evaluating the follow-up processes of the groups with and without radioactive iodine ablation in patients followed up with these diagnoses. Material and Methods: The 49 patients older than 18 years of age and followed for at least 12 months, who were performed subtotal and total thyroidectomy between 2015 and 2020 and were diagnosed with WDT- UMP, FT-UMP, HCN-UMP, and NIFTP according to histopathological examination were included to the study. Results: Tumor type rates did not differ between the groups that received and did not receive RAI treatment (p=0.361). The mean follow-up period did not differ between the groups that received and did not receive RAI treatment. Also the rates of RAI treatment according to tumor size did not differ (p=0.413). Tumor size was larger than 4 cm in 13 patients, and 1 patient from this group had received RAI treatment. Recurrence was not detected in the 49 patients included in our study who received or not receive RAI treatment. Conclusions: Some studies recommend giving RAI to these borderline thyroid tumors larger than 4 cm. But in our study no recurrence was detected in patients who did not receive RAI. That supports the view that patients could be followed without RAI treatment even if they are large tumors.

Keywords:

Noninvasive Follicular Thyroid Neoplasm (NIFTP), Well diferantiated thyroid tumor with uncertain malignity potential (WDT-UMP), follicular thyroid tumor with uncertain malignity potential (FT-UMP) Hurtle cell neoplasia with uncertain malignity potential (HCN-UMP), RAI ablation, recurrence,

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Cabanillas ME, McFadden DG, Durante C. Thyroid cancer. Lancet. 2016 Dec 3;388(10061):2783-2795. doi: 10.1016/S0140- 6736(16)30172-6.
Hanley JP, Jackson E, Morrissey LA, Rizzo DM, Sprague BL, Sarkar IN, Carr FE. Geospatial and temporal analysis of thyroid cancer incidence in a rural population. Thyroid. 2015 Jul;25(7):812-22. doi: 10.1089/thy.2015.0039.
Topaloğlu O, Başer H, Altınboğa AA, Ulusoy S, Ersoy R, Çakır B. The evaluation of clinicopathologic features of differentiated thyroid cancers. Ankara Med J, 2018;18(3):419‐29. doi: 10.17098/ amj.461658.
Bai Y, Kakudo K, Jung CK. Updates in the pathologic classification of thyroid neoplasms: a review of the world health organization classification. Endocrinol Metab (Seoul). 2020 Dec;35(4):696-715. doi: 10.3803/EnM.2020.807.
Liu Z, Zhou G, Nakamura M, Koike E, Li Y, Ozaki T, Mori I, Taniguchi E, Kakudo K. Encapsulated follicular thyroid tumor with equivocal nuclear changes, so-called well-differentiated tumor of uncertain malignant potential: a morphological, immunohistochemical, and molecular appraisal. Cancer Sci. 2011 Jan;102(1):288-94. doi: 10.1111/j.1349-7006.2010.01769.x.
Richard C, Debreuve-Theresette A, Patey M, Brabencova E, Filieri C, Zalzali M, Schvartz C. Long-term progression of non- invasive follicular thyroid neoplasm with papillary-like nuclear features: A single-center retrospective study of the French Marne- Ardennes thyroid cancer registry. Ann Endocrinol (Paris). 2020 Feb;81(1):34-8. doi: 10.1016/j.ando.2019.12.001.
Xu B, Tallini G, Scognamiglio T, Roman BR, Tuttle RM, Ghossein RA. Outcome of large noninvasive follicular thyroid neoplasm with papillary-like nuclear features. Thyroid. 2017 Apr;27(4):512-7. doi: 10.1089/thy.2016.0649.
Nechifor-Boila A, Borda A, Sassolas G, Hafdi-Nejjari Z, Cătană R, Borson-Chazot F, Berger N, Decaussin-Petrucci M. Thyroid tumors of uncertain malignant potential: morphologic and imunohistochemical analysis of 29 cases. Pathol Res Pract. 2015 Apr;211(4):320-5. doi: 10.1016/j.prp.2014.12.005.
Juhlin CC, Bränström R, Shabo I, Höög A. Clear cell variant of a follicular thyroid tumor with uncertain malignant potential: A case report. Int J Surg Pathol.2019 May;27(3):290-3. doi: 10.1177/1066896918809490.