Papillary thyroid cancer is the most common cause of thyroid cancer. The follicular variant of papillary thyroid cancer accounts for the majority of thyroid cancer cases in the United States. In 2016, the encapsulated follicular variant of papillary thyroid cancer with no evidence of spread into the thyroid capsule or into the blood vessels seen under the microscope was renamed as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP), and was suggested that it was a non-cancer diagnosis. Because a study showed that patients with NIFTP had an excellent prognosis without recurrence, it is no longer recommended for patients with NIFTP to have additional treatments such as completion thyroidectomy surgeries or radioactive iodine therapy.
The current study looked at patients with large (>4cm) NIFTP to determine whether the prognosis and recurrence risk remains low even though the tumors are big. The authors want to make sure that patients can be reassured that the renaming of a cancer to a non-cancer diagnosis (NIFTP) is appropriate for large tumors and that additional treatments such as radioactive iodine therapy would not be required.
THE FULL ARTICLE TITLE:
Xu B et al. Outcome of large noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Thyroid. 2017 Apr;27(4):512-517.
SUMMARY OF THE STUDY
A group of 4 hospitals reviewed their databases of patients who had thyroid surgery between the years 1982 to 2015. They found 79 cases that met criteria for NIFTP tumors greater than 4 cm. The patient files were reviewed to get information about management and patient outcomes. There were more women than men (ratio 1.8:1). The average size of the NIFTP tumors was 4.5 cm (ranging from 4 to 8 cm). The tumors did not extend beyond the thyroid, and of the 25 patients who had lymph nodes removed at the time of surgery, none had cancer metastases.