Evidence map›Paper›PMID 40165363›Full record

Observational studyThe Journal of clinical endocrinology and metabolism2025

Prospective Validation of ATA Risk Score for Papillary Thyroid Microcarcinoma: An ITCO Real-World Study.

Simone De Leo, Giulia Brigante, Silvia D'Elia, Simona Censi, Bruno Madeo, Silvia Morelli, Alice Nervo, Andrea Repaci, Clotilde Sparano, Ilaria Stramazzo and 52 more

Registry-linked trialAbstract readValidation StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The Journal of clinical endocrinology and metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04031339 (Multicenter, Prospective, Observational Study of Clinical Outcomes of Thyroid Cancer), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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.

NCT04031339 unknown statusnot on this map

Multicenter, Prospective, Observational Study of Clinical Outcomes of Thyroid Cancer

TypeobservationalSponsorUniversity of Roma La SapienzaRan2013 to 2025Enrolled15,000ConditionsThyroid NeoplasmsArmsStandard treatment
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
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

62 authors.

Simone De LeoEndocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan 20149, Italy.
Giulia BriganteUnit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41125, Italy.ORCID 0000-0001-8426-4502
Silvia D'EliaDepartment of Statistical Sciences, Sapienza University of Rome, Rome 00185, Italy.
Simona CensiOperative Unit of Endocrinology Department of Medicine-DIMED University of Padua, Padua 35128, Italy.
Bruno MadeoUnit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41125, Italy.ORCID 0000-0003-2881-982X
Silvia MorelliDepartment of Medicine and Surgery, University of Perugia, Perugia 06129, Italy.
Alice NervoOncological Endocrinology Unit, Department of Medical Sciences, Città della Salute e della Scienza Hospital, University of Turin, Turin 10126, Italy.
Andrea RepaciDivision of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy.
Clotilde SparanoEndocrinology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence 50134, Italy.ORCID 0000-0002-3766-4682
Ilaria StramazzoEndocrinology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina 04100, Italy.
Camilla ViriliEndocrinology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina 04100, Italy.
Francesco BertagnaNuclear Medicine, University of Brescia and Spedali Civili di Brescia, Brescia 25123, Italy.
Francesco DondiNuclear Medicine, University of Brescia and Spedali Civili di Brescia, Brescia 25123, Italy.
Efisio PuxedduDepartment of Medicine and Surgery, University of Perugia, Perugia 06129, Italy.
Edoardo TalpacciDepartment of Medicine and Surgery, University of Perugia, Perugia 06129, Italy.
Maria Chiara ZatelliSection of Endocrinology, Geriatrics and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara 44121, Italy.
Maria Rosaria AmbrosioSection of Endocrinology, Geriatrics and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara 44121, Italy.
Francesco FelicettiOncological Endocrinology Unit, Department of Medical Sciences, Città della Salute e della Scienza Hospital, University of Turin, Turin 10126, Italy.
Alessandro PiovesanOncological Endocrinology Unit, Department of Medical Sciences, Città della Salute e della Scienza Hospital, University of Turin, Turin 10126, Italy.
Luisa PetroneEndocrinology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence 50134, Italy.
Virginia AdornatoEndocrinology Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence 50134, Italy.
Matteo TrevisanEndocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan 20149, Italy.
Laura FugazzolaEndocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan 20149, Italy.
Chiara MeleEndocrinology, Department of Translational Medicine, University of Piemonte Orientale, Novara 28100, Italy.
Marco ZavattaroEndocrinology, Department of Translational Medicine, University of Piemonte Orientale, Novara 28100, Italy.
Erica SolaroliUnit of Endocrinology, Department of Medicine, AUSL Bologna, Bologna 40124, Italy.
Nicola SalituroUnit of Endocrinology, Department of Medicine, AUSL Bologna, Bologna 40124, Italy.
Mattia RossiEndocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin 10126, Italy.
Loredana PaganoEndocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin 10126, Italy.
Alessandra ColapintoDivision of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy.
Cristina BassoDivision of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy.
Graziano CeresiniUnit of Internal Medicine and Oncological Endocrinology, University Hospital of Parma, Parma 43126, Italy.
Michela MarinaUnit of Internal Medicine and Oncological Endocrinology, University Hospital of Parma, Parma 43126, Italy.
Umberto CrocettiDepartment of Medical Sciences, Hospital "Casa Sollievo della Sofferenza," IRCCS, San Giovanni Rotondo 71013, Italy.
Michela MassaDepartment of Medical Sciences, Hospital "Casa Sollievo della Sofferenza," IRCCS, San Giovanni Rotondo 71013, Italy.
Maurilio DeandreaUO Endocrinologia, Diabetologia e Malattie del metabolismo, AO Ordine Mauriziano, Torino 101128, Italy.
Francesca RettaUO Endocrinologia, Diabetologia e Malattie del metabolismo, AO Ordine Mauriziano, Torino 101128, Italy.
Giovanna SpiazziEndocrinology and Diabetology Unit, Department of Medicine, Azienda Ospedaliera-Universitaria di Verona, Verona 37126, Italy.
Nicoletta RolliEndocrinology and Diabetology Unit, Department of Medicine, Azienda Ospedaliera-Universitaria di Verona, Verona 37126, Italy.
Rocco BrunoEndocrine Unit, Tinchi Hospital, Asm Matera, Matera 75100, Italy.
Antonella CarboneEndocrine Unit, Tinchi Hospital, Asm Matera, Matera 75100, Italy.
Mario RotondiIstituti Clinici Scientifici Maugeri IRCCS, Unit of Endocrinology and Metabolism and Department of Internal Medicine and Therapeutics, University of Pavia, Pavia 27100, Italy.
Flavia MagriIstituti Clinici Scientifici Maugeri IRCCS, Unit of Endocrinology and Metabolism and Department of Internal Medicine and Therapeutics, University of Pavia, Pavia 27100, Italy.
Poupak FallahiDepartment of Surgery, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa 56100, Italy.
Maria Grazia ChiofaloDepartment Head and Neck, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples 80131, Italy.
Maria Giulia SantaguidaEndocrinology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina 04100, Italy.
Salvatore MontiEndocrinology and Diabetes Unit, Azienda Ospedaliero-Universitaria Sant'Andrea, Sapienza University of Rome, Rome 00185, Italy.
Tommaso PorcelliDepartment of Public Health, University of Naples "Federico II,"  Naples 80138, Italy.
Roberto CastelloDepartment of Medicine, Hospital and University of Verona, Verona 37134, Italy.
Alfonso SagnellaDepartment of Medicine, Surgery and Neuroscience, Section of Endocrinology, University of Siena, Siena 53100, Italy.
Cristina ClausiOperative Unit of Endocrinology Department of Medicine-DIMED University of Padua, Padua 35128, Italy.
Giulia Di DalmaziDepartment of Medicine and Aging Sciences, University "G. d'Annunzio" of Chieti-Pescara, Chieti 66100, Italy.
Dario TuminoDepartment of Clinical and Experimental Medicine, University of Catania, Catania 95122, Italy.
Andrea PalermoUnit of Metabolic Bone and Thyroid Diseases, Fondazione Policlinico Campus Bio-Medico and Endocrinology and Diabetes Campus Bio-Medico University, Rome 00128, Italy.
Antonio BrunettiDepartment of Health Sciences, University of "Magna Græcia,"  Catanzaro 88100, Italy.
Andrea LaniaDepartment of Biomedical Sciences, Humanitas University, and Endocrinology, Diabetology and Andrology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan 20089, Italy.
Andrea LiveraniDepartment of Surgery, Regina Apostolorum Hospital, Albano Laziale, Rome 00041, Italy.
Cosimo DuranteDept. of Translational and Precision Medicine, Sapienza University of Rome, Rome 00161, Italy.
Umberto Ferraro PetrilloDepartment of Statistical Sciences, Sapienza University of Rome, Rome 00185, Italy.
Marco Alfo'Department of Statistical Sciences, Sapienza University of Rome, Rome 00185, Italy.
Sebastiano FilettiDept. of Translational and Precision Medicine, Sapienza University of Rome, Rome 00161, Italy.
Giorgio GraniDept. of Translational and Precision Medicine, Sapienza University of Rome, Rome 00161, Italy.ORCID 0000-0002-0388-1283

Funding

Italian Ministry of Health to S.D.L., M.T. and L.F
6 · The paper itself

Abstract

contextThe risk of recurrence of papillary thyroid carcinoma (PTC) smaller than 1 cm (microPTC) is low. Predictors of disease persistence in microPTC are still unclear.

objectiveTo compare the clinical and pathological characteristics of microPTCs with macrocarcinomas (PTC > 1 cm), identifying the predictors of biochemical and structural incomplete response 1 year after initial treatment in microPTC.

methodsWe included patients consecutively enrolled in the Italian Thyroid Cancer Observatory (NCT04031339), and selected patients with a histological diagnosis of PTC for whom complete pathological, clinical, treatment information, and results at the 1-year follow-up visits were available.

resultsAmong 5038 patients in the cohort, 2345 (46.5%) had a microPTC. Patients with microPTCs had tumors with more indolent pathological features: only 3% of patients were classified as high risk according to the American Thyroid Association (ATA) risk stratification system for persistent or recurrent disease and 1% had distant metastases at diagnosis. MicroPTCs had a significantly better outcome: only 5% had a biochemical response and 2.3% a structural incomplete (SIR) response. Distant metastases at diagnosis were the best predictor of SIR in microPTCs (OR 5.13, 95% CI 1.11-23.73, P = .04). In a subgroup of 925 patients treated by total thyroidectomy and radioiodine treatment, the best predictor of SIR was the ATA high risk (OR 5.47, 95% CI 1.42-21.04, P = .01).

conclusionOur study confirms the favorable initial outcome of microPTC in a large series. We demonstrate that the ATA risk classification is reliable in predicting biochemical and structural persistence in patients with microPTC. Distant metastases, although rare, remain the best predictor of structural persistence at 1-year follow-up. These findings underscore the importance of tailored management strategies based on comprehensive risk stratification, rather than solely on tumor size.

Indexed as

Carcinoma, PapillaryNeoplasm Recurrence, LocalThyroid NeoplasmsAdultAgedFemaleFollow-Up StudiesHumansItalyMaleMiddle AgedPrognosisProspective StudiesRisk AssessmentRisk FactorsThyroidectomymicrocarcinomaoutcomepapillary thyroid carcinomapredictorsthyroid cancer

Identifiers

PMID40165363
PMCPMC12623051

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