Evidence map›Paper›PMID 29204912›Full record

ArticleEndocrine2018

Should subcentimeter non-invasive encapsulated, follicular variant of papillary thyroid carcinoma be included in the noninvasive follicular thyroid neoplasm with papillary-like nuclear features category?

Bin Xu, Nada Farhat, Justine A Barletta, Yin P Hung, Dario de Biase, Gian Piero Casadei, Ayse Mine Onenerk, R Michael Tuttle, Benjamin R Roman, Nora Katabi and 5 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Endocrine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Guideline
  2. Pooled it
  3. Follicular-Patterned Lesions of the Thyroid Gland.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2026
    Review
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  8. Article
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  17. Deep learning prediction of BRAF-RAS gene expression signature identifies noninvasive follicular thyroid neoplasms with papillary-like nuclear features.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2021
    Article
  18. Article
  19. Article
  20. [Pathology and molecular profile of differentiated thyroid carcinoma].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2020
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Bin XuSunnybrook Health Sciences Centre, Toronto, ON, Canada.
Nada FarhatDepartment of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Justine A BarlettaDepartment of Pathology, Brigham and Women's Hospital, Boston, MA, USA.
Yin P HungDepartment of Pathology, Brigham and Women's Hospital, Boston, MA, USA.
Dario de BiaseDepartment of Pharmacy and Biotechnology (Dipartimento di Farmacia e Biotecnologie), University of Bologna, Bologna, Italy.
Gian Piero CasadeiAnatomic Pathology Unit, Ospedale Maggiore, Bologna, Italy.
Ayse Mine OnenerkDepartments of Pathology, Massachusetts General Hospital, Boston, MA, USA.
R Michael TuttleDepartments of Medicine, and Memorial Sloan Kettering Cancer center, New York, NY, USA.
Benjamin R RomanDepartment of Surgery, Memorial Sloan Kettering Cancer center, New York, NY, USA.
Nora KatabiDepartment of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Vania NoséDepartment of Pathology, Harvard Medical School, Boston, MA, USA.
Peter SadowDepartment of Pathology, Harvard Medical School, Boston, MA, USA.
Giovanni TalliniDepartment of Medicine (Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale), University of Bologna School of Medicine, Bologna, Italy.
William C FaquinDepartment of Pathology, Harvard Medical School, Boston, MA, USA.
Ronald GhosseinDepartment of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. ghosseir@mskcc.org.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
Italian Government-Ministero della Salute Grant RF-2011-02350857NCI NIH HHS P30 CA008748NCI NIH HHS P30CA008748
6 · The paper itself

Abstract

objectiveIn 2016, non-invasive, well-circumscribed and encapsulated, follicular variant of papillary thyroid carcinoma (NI-EFV PTC) was reclassified as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) in order to reduce overtreatment of this indolent tumor. However, the study cohort did not include subcentimeter tumors, i.e., papillary thyroid microcarcinoma (mPTC) with NI-EFV morphology, and such lesions are still regarded and staged by most pathologists as microcarcinomas. It is therefore crucial to evaluate the clinical outcome of subcentimeter NI-EFVs.

methodsA total of 52 patients with unifocal mPTC, NI-EFV from five tertiary hospitals who had at least one year clinical follow-up (FU) without post-operative RAI administration were included in the study. A control group of 57 invasive mPTC follicular variant was also included.

resultsThe median tumor size was 0.44 cm (range 0.1-0.9 cm). There were no distant or lymph node metastases at diagnosis in all patients. Twenty-three patients (44%) underwent lobectomy alone, while the remaining received total thyroidectomy. No recurrence was observed in the entire cohort (n = 52) including all 38 patients with at least 2 years of FU (median FU: 6.3 years). Among 25 patients with ≥5 years of FU, none recurred with a median FU of 9.6 years (range 5.2-18.1 years). In contrast, in the control group with invasive mPTC follicular variant, there were 5 (9%) patients with nodal metastasis at presentation and 1 (2%) who displayed nodal recurrence.

conclusionPapillary thyroid microcarcinoma, NI-EFV, when stringently selected for, lacks metastasis at presentation and follows an extremely indolent clinical course, even when treated conservatively without RAI therapy. Provided stringent inclusion criteria are met, classification of subcentimeter mPTC, NI-EFV as NIFTP should be considered in order to avoid overtreatment of these biologically indolent lesions.

Indexed as

Adenocarcinoma, FollicularAdultAgedAged, 80 and overCarcinoma, PapillaryCell NucleusFemaleHumansMaleMiddle AgedNeoplasm InvasivenessNeoplasm StagingRetrospective StudiesThyroid Cancer, PapillaryThyroid NeoplasmsTumor BurdenFollicular variantNon-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP)Papillary microcarcinomaPapillary thyroid carcinoma

Identifiers

PMID29204912
PMCPMC5766404

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.