Follicular proliferation TIR3B: the role of total thyroidectomy vs lobectomy
Abstract Background TIR3B thyroid nodules are considered to be at risk of malignancy (15–30%) but guidelines recommend conservative surgery with lobectomy with primary diagnostic porpoise. Risk stratification mainly based on ultrasound, elastography and genetic mutations usually may influences the s...
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BMC
2019-04-01
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Series: | BMC Surgery |
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Online Access: | http://link.springer.com/article/10.1186/s12893-019-0485-9 |
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author | Andrea Polistena Alessandro Sanguinetti Roberta Lucchini Stefano Avenia Sergio Galasse Raffaele Farabi Massimo Monacelli Nicola Avenia |
author_facet | Andrea Polistena Alessandro Sanguinetti Roberta Lucchini Stefano Avenia Sergio Galasse Raffaele Farabi Massimo Monacelli Nicola Avenia |
author_sort | Andrea Polistena |
collection | DOAJ |
description | Abstract Background TIR3B thyroid nodules are considered to be at risk of malignancy (15–30%) but guidelines recommend conservative surgery with lobectomy with primary diagnostic porpoise. Risk stratification mainly based on ultrasound, elastography and genetic mutations usually may influences the surgical approach. Methods We retrospectively analyzed 52 cases of TIR3B underwent between 2015 and 2017 total thyroidectomy (TT) and lobectomy (L), focusing mainly on the observed rate of malignancy. Chi-squared test and Fisher’s exact probability test were used for analysis, considering a P values less than 0.05 as significant. Results Out of 52 patients 49 underwent TT and 3 L. In TT group a multinodular goiter was associated in 67.3% of patients. Malignancy rate was 81.6 and 33.3% respectively after TT and L (P 0.003). Multicentric and contralateral tumors were detected respectively in 36.7% and in 32.6% of patients underwent TT. No main post-operative complications were registered. Conclusions Ultrasound and elastography are useful to define within the TIR3B group those lesions at higher risk and therefore requiring a more radical approach. TT seems an appropriate approach to TIR3B lesions, especially in multinodular goiter, considering the incidence of malignancy with probably higher rate than previously reported. |
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id | doaj.art-c70339f847344e88a4d99217b5e8b9d4 |
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issn | 1471-2482 |
language | English |
last_indexed | 2024-12-13T02:57:04Z |
publishDate | 2019-04-01 |
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series | BMC Surgery |
spelling | doaj.art-c70339f847344e88a4d99217b5e8b9d42022-12-22T00:01:56ZengBMCBMC Surgery1471-24822019-04-0118S11510.1186/s12893-019-0485-9Follicular proliferation TIR3B: the role of total thyroidectomy vs lobectomyAndrea Polistena0Alessandro Sanguinetti1Roberta Lucchini2Stefano Avenia3Sergio Galasse4Raffaele Farabi5Massimo Monacelli6Nicola Avenia7General Surgery and Surgical Specialties Unit, S. Maria University Hospital Terni and University of Perugia, Medical SchoolGeneral Surgery and Surgical Specialties Unit, S. Maria University Hospital Terni and University of Perugia, Medical SchoolGeneral Surgery and Surgical Specialties Unit, S. Maria University Hospital Terni and University of Perugia, Medical SchoolGeneral Surgery and Surgical Specialties Unit, S. Maria University Hospital Terni and University of Perugia, Medical SchoolGeneral Surgery and Surgical Specialties Unit, S. Maria University Hospital Terni and University of Perugia, Medical SchoolPathology Unit, S. Maria University Hospital Terni and University of Perugia, Medical SchoolGeneral Surgery and Surgical Specialties Unit, S. Maria University Hospital Terni and University of Perugia, Medical SchoolGeneral Surgery and Surgical Specialties Unit, S. Maria University Hospital Terni and University of Perugia, Medical SchoolAbstract Background TIR3B thyroid nodules are considered to be at risk of malignancy (15–30%) but guidelines recommend conservative surgery with lobectomy with primary diagnostic porpoise. Risk stratification mainly based on ultrasound, elastography and genetic mutations usually may influences the surgical approach. Methods We retrospectively analyzed 52 cases of TIR3B underwent between 2015 and 2017 total thyroidectomy (TT) and lobectomy (L), focusing mainly on the observed rate of malignancy. Chi-squared test and Fisher’s exact probability test were used for analysis, considering a P values less than 0.05 as significant. Results Out of 52 patients 49 underwent TT and 3 L. In TT group a multinodular goiter was associated in 67.3% of patients. Malignancy rate was 81.6 and 33.3% respectively after TT and L (P 0.003). Multicentric and contralateral tumors were detected respectively in 36.7% and in 32.6% of patients underwent TT. No main post-operative complications were registered. Conclusions Ultrasound and elastography are useful to define within the TIR3B group those lesions at higher risk and therefore requiring a more radical approach. TT seems an appropriate approach to TIR3B lesions, especially in multinodular goiter, considering the incidence of malignancy with probably higher rate than previously reported.http://link.springer.com/article/10.1186/s12893-019-0485-9Follicular proliferationTIR3BThyroid cancerMalignancySurgeryTotal thyroidectomy |
spellingShingle | Andrea Polistena Alessandro Sanguinetti Roberta Lucchini Stefano Avenia Sergio Galasse Raffaele Farabi Massimo Monacelli Nicola Avenia Follicular proliferation TIR3B: the role of total thyroidectomy vs lobectomy BMC Surgery Follicular proliferation TIR3B Thyroid cancer Malignancy Surgery Total thyroidectomy |
title | Follicular proliferation TIR3B: the role of total thyroidectomy vs lobectomy |
title_full | Follicular proliferation TIR3B: the role of total thyroidectomy vs lobectomy |
title_fullStr | Follicular proliferation TIR3B: the role of total thyroidectomy vs lobectomy |
title_full_unstemmed | Follicular proliferation TIR3B: the role of total thyroidectomy vs lobectomy |
title_short | Follicular proliferation TIR3B: the role of total thyroidectomy vs lobectomy |
title_sort | follicular proliferation tir3b the role of total thyroidectomy vs lobectomy |
topic | Follicular proliferation TIR3B Thyroid cancer Malignancy Surgery Total thyroidectomy |
url | http://link.springer.com/article/10.1186/s12893-019-0485-9 |
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