Surgical Management of Indeterminate Thyroid Nodules across Different World Regions: Results from a Retrospective Multicentric (the MAIN-NODE) Study
Indeterminate thyroid nodules (ITNs) are characterized by an expected malignancy ranging from 5% to 30%, with most patients undergoing a diagnostic, rather than therapeutic, operation. The aim of our study was to compare the approach to ITNs across different regions of the world. In this retrospecti...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/15/3996 |
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| author | Gian Luigi Canu Federico Cappellacci Ahmed Abdallah Islam Elzahaby David Figueroa-Bohorquez Eleonora Lori Julie A. Miller Sergio Zúñiga Pavia Pilar Pinillos Atcharaporn Pongtippan Saleh Saleh Saleh Salvatore Sorrenti Chutintorn Sriphrapradang Pietro Giorgio Calò Fabio Medas |
| author_facet | Gian Luigi Canu Federico Cappellacci Ahmed Abdallah Islam Elzahaby David Figueroa-Bohorquez Eleonora Lori Julie A. Miller Sergio Zúñiga Pavia Pilar Pinillos Atcharaporn Pongtippan Saleh Saleh Saleh Salvatore Sorrenti Chutintorn Sriphrapradang Pietro Giorgio Calò Fabio Medas |
| author_sort | Gian Luigi Canu |
| collection | DOAJ |
| description | Indeterminate thyroid nodules (ITNs) are characterized by an expected malignancy ranging from 5% to 30%, with most patients undergoing a diagnostic, rather than therapeutic, operation. The aim of our study was to compare the approach to ITNs across different regions of the world. In this retrospective, multicentric, international study, according to the WHO classification, we identified the South East Asian Region (SEAR), the Americas Region (AMR), the Eastern Mediterranean Region (EMR), the Europe Region (EUR), and the Western Pacific Region (WPR). One high-volume thyroid centre was included for each region. Demographic, preoperative, and pathologic data were compared among the different regions. Overall, 5737 patients from five high-volume thyroid centres were included in this study. We found that the proportion of ITNs over the global activity for thyroid disease was higher in the EUR (37.6%) than in the other regions (21.1–23.6%). In the EMR, the patients were significantly younger (with a mean of 43.1 years) than in the other regions (range, 48.8–57.4 years). The proportion of lobectomy was significantly higher in the WPR, where 83.2% (114/137) of patients received this treatment, than in the other regions, where lobectomies were performed in 44.1–58.1% of patients. The pathological diagnosis of malignancy was significantly higher in the SEAR centre, being over 60%, than in centres of the other regions, where it ranged from 26.3% to 41.3%. The occurrence of lymph node metastases was higher in the WPR (27.8%), AMR (26.9%), and EMR (20%) centres than in the EUR and SEAR centres, where it was lower than 10%. In summary, we found in our study different approaches and outcomes in the diagnosis and treatment of ITNs among countries. Overall, almost 60% of patients with ITNs who underwent surgery actually presented a benign disease, potentially undergoing an unnecessary operation. |
| first_indexed | 2024-03-11T00:30:25Z |
| format | Article |
| id | doaj.art-777dc08d8ea84e5594124a9eb9cb9d08 |
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| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T00:30:25Z |
| publishDate | 2023-08-01 |
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| record_format | Article |
| series | Cancers |
| spelling | doaj.art-777dc08d8ea84e5594124a9eb9cb9d082023-11-18T22:44:11ZengMDPI AGCancers2072-66942023-08-011515399610.3390/cancers15153996Surgical Management of Indeterminate Thyroid Nodules across Different World Regions: Results from a Retrospective Multicentric (the MAIN-NODE) StudyGian Luigi Canu0Federico Cappellacci1Ahmed Abdallah2Islam Elzahaby3David Figueroa-Bohorquez4Eleonora Lori5Julie A. Miller6Sergio Zúñiga Pavia7Pilar Pinillos8Atcharaporn Pongtippan9Saleh Saleh Saleh10Salvatore Sorrenti11Chutintorn Sriphrapradang12Pietro Giorgio Calò13Fabio Medas14Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, ItalyDepartment of Surgical Sciences, University of Cagliari, 09124 Cagliari, ItalySurgical Oncology, Mansoura University, Mansoura 35516, EgyptSurgical Oncology, Mansoura University, Mansoura 35516, EgyptHead and Neck Surgery, Hospital Universitario Nacional de Colombia, Bogotá 250247, ColombiaDepartment of Surgery, “Sapienza” University of Rome, 00185 Rome, ItalyThe Royal Melbourne Hospital and Epworth Hospital, Melbourne, VIC 3121, AustraliaHead and Neck Surgery, Hospital Universitario Nacional de Colombia, Bogotá 250247, ColombiaHead and Neck Surgery, Hospital Universitario Nacional de Colombia, Bogotá 250247, ColombiaDepartment of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandSurgical Oncology, Mansoura University, Mansoura 35516, EgyptDepartment of Surgery, “Sapienza” University of Rome, 00185 Rome, ItalyDepartment of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandDepartment of Surgical Sciences, University of Cagliari, 09124 Cagliari, ItalyDepartment of Surgical Sciences, University of Cagliari, 09124 Cagliari, ItalyIndeterminate thyroid nodules (ITNs) are characterized by an expected malignancy ranging from 5% to 30%, with most patients undergoing a diagnostic, rather than therapeutic, operation. The aim of our study was to compare the approach to ITNs across different regions of the world. In this retrospective, multicentric, international study, according to the WHO classification, we identified the South East Asian Region (SEAR), the Americas Region (AMR), the Eastern Mediterranean Region (EMR), the Europe Region (EUR), and the Western Pacific Region (WPR). One high-volume thyroid centre was included for each region. Demographic, preoperative, and pathologic data were compared among the different regions. Overall, 5737 patients from five high-volume thyroid centres were included in this study. We found that the proportion of ITNs over the global activity for thyroid disease was higher in the EUR (37.6%) than in the other regions (21.1–23.6%). In the EMR, the patients were significantly younger (with a mean of 43.1 years) than in the other regions (range, 48.8–57.4 years). The proportion of lobectomy was significantly higher in the WPR, where 83.2% (114/137) of patients received this treatment, than in the other regions, where lobectomies were performed in 44.1–58.1% of patients. The pathological diagnosis of malignancy was significantly higher in the SEAR centre, being over 60%, than in centres of the other regions, where it ranged from 26.3% to 41.3%. The occurrence of lymph node metastases was higher in the WPR (27.8%), AMR (26.9%), and EMR (20%) centres than in the EUR and SEAR centres, where it was lower than 10%. In summary, we found in our study different approaches and outcomes in the diagnosis and treatment of ITNs among countries. Overall, almost 60% of patients with ITNs who underwent surgery actually presented a benign disease, potentially undergoing an unnecessary operation.https://www.mdpi.com/2072-6694/15/15/3996indeterminate thyroid nodulesthyroid cancerfollicular thyroid neoplasmthyroidectomy |
| spellingShingle | Gian Luigi Canu Federico Cappellacci Ahmed Abdallah Islam Elzahaby David Figueroa-Bohorquez Eleonora Lori Julie A. Miller Sergio Zúñiga Pavia Pilar Pinillos Atcharaporn Pongtippan Saleh Saleh Saleh Salvatore Sorrenti Chutintorn Sriphrapradang Pietro Giorgio Calò Fabio Medas Surgical Management of Indeterminate Thyroid Nodules across Different World Regions: Results from a Retrospective Multicentric (the MAIN-NODE) Study Cancers indeterminate thyroid nodules thyroid cancer follicular thyroid neoplasm thyroidectomy |
| title | Surgical Management of Indeterminate Thyroid Nodules across Different World Regions: Results from a Retrospective Multicentric (the MAIN-NODE) Study |
| title_full | Surgical Management of Indeterminate Thyroid Nodules across Different World Regions: Results from a Retrospective Multicentric (the MAIN-NODE) Study |
| title_fullStr | Surgical Management of Indeterminate Thyroid Nodules across Different World Regions: Results from a Retrospective Multicentric (the MAIN-NODE) Study |
| title_full_unstemmed | Surgical Management of Indeterminate Thyroid Nodules across Different World Regions: Results from a Retrospective Multicentric (the MAIN-NODE) Study |
| title_short | Surgical Management of Indeterminate Thyroid Nodules across Different World Regions: Results from a Retrospective Multicentric (the MAIN-NODE) Study |
| title_sort | surgical management of indeterminate thyroid nodules across different world regions results from a retrospective multicentric the main node study |
| topic | indeterminate thyroid nodules thyroid cancer follicular thyroid neoplasm thyroidectomy |
| url | https://www.mdpi.com/2072-6694/15/15/3996 |
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