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. 2024 Dec 7;16(23):4109.
doi: 10.3390/cancers16234109.

Influence of Tumor Laterality and Focality on Clinical Implications and Tumor Advancement in Well-Differentiated Thyroid Cancer

Michał Miciak  1 , Krzysztof Jurkiewicz  1 , Anna Dziekiewicz  1 , Szymon Biernat  1 , Michał Kisiel  1 , Beata Wojtczak  2 , Dorota Diakowska  3 , Krzysztof Kaliszewski  1
Affiliations

Influence of Tumor Laterality and Focality on Clinical Implications and Tumor Advancement in Well-Differentiated Thyroid Cancer

Michał Miciak et al. Cancers (Basel). .

Abstract

Background: The accurate preoperative diagnosis of TC plays a very important role in the selection of an appropriate treatment strategy. In addition to the hypoechogenicity of thyroid lesions on ultrasound and the presence of microcalcifications or high cell atypia on FNAB, highlighting the features of laterality and focality and ascertaining their influence (alone or combined) on TC staging and appropriate treatment are crucial.

Materials and methods: A retrospective analysis of the clinical data of 697 patients admitted to the study center between 2008 and 2023 was conducted. Preoperative data (age, sex, type of surgery, ultrasound, and FNAB data) and postoperative histopathological data indicating TC advancement (pTNM, extrathyroidal extension, vascular invasion) were collected and analyzed. Patients presenting well-differentiated TCs (papillary TC and follicular TC) were isolated for better clinical evaluation. Finally, patients were divided into four groups according to their laterality and focality features, and the influences of combinations of these features on TC advancement were analyzed.

Results: The largest group included patients with unilateral and solitary TC (n = 461). This group had the lowest rate of negative prognostic features: extrathyroidal extension, lymph node invasion, distant metastases, and vascular invasion (25.81%, 19.96%, 3.69%, and 26.46%, respectively). In contrast, the group with bilateral and multifocal TC (n = 40) presented the highest percentages of the mentioned features (82.50%, 82.50%, 7.50%, and 77.50%, respectively). All the results were statistically significant (p < 0.0001).

Conclusions: Laterality and focality features may be important parameters in the management of TC and should be accurately determined. These features should be combined and a more aggressive treatment method should be selected to reduce the reoperation rate.

Keywords: thyroid cancer; thyroid cancer diagnostics; thyroid cancer management; thyroid surgery; tumor focality; tumor laterality.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Study group selection process. A total of 6019 patients were admitted to the University Centre of General and Oncological Surgery, Department of General Surgery for thyroid disease during the observational study between January 2008 and December 2023. Patients underwent diagnostic evaluation, including fine-needle aspiration biopsy (FNAB), thyroid ultrasound examination, and laboratory tests. Patients who were eligible for surgical treatment also underwent histopathological examination to ascertain the histological type of lesion, tumor characteristics, pTNM stage, presence of thyroid vascular infiltration and thyroid capsule invasion, and presence of microcalcifications or lymph node metastases.
Figure 2
Figure 2
Distribution of TC features in each studied patient group in the aggregate.
See this image and copyright information in PMC

References

    1. Pawar A., Joshi P., Singhai A. An Assessment of Thyroid Dysfunction and Related Parameters in Patients With Systemic Autoimmune Disorders. Cureus. 2023;15:e42783. doi: 10.7759/cureus.42783. - DOI - PMC - PubMed
    1. Alyahya A., AlNaim A., AlBahr A.W., Almansour F., Elshebiny A. Knowledge of Thyroid Disease Manifestations and Risk Factors Among Residents of the Eastern Province, Saudi Arabia. Cureus. 2021;13:e13035. doi: 10.7759/cureus.13035. - DOI - PMC - PubMed
    1. Leso V., Vetrani I., De Cicco L., Cardelia A., Fontana L., Buonocore G., Iavicoli I. The Impact of Thyroid Diseases on the Working Life of Patients: A Systematic Review. Int. J. Environ. Res. Public Health. 2020;17:4295. doi: 10.3390/ijerph17124295. - DOI - PMC - PubMed
    1. Monaco F. Classification of Thyroid Diseases: Suggestions for a Revision. J. Clin. Endocrinol. Metab. 2003;88:1428–1432. doi: 10.1210/jc.2002-021260. - DOI - PubMed
    1. Haugen B.R., Alexander E.K., Bible K.C., Doherty G.M., Mandel S.J., Nikiforov Y.E., Pacini F., Randolph G.W., Sawka A.M., Schlumberger M., et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26:1–133. doi: 10.1089/thy.2015.0020. - DOI - PMC - PubMed

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