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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Main Authors: Andrea Polistena, Alessandro Sanguinetti, Roberta Lucchini, Stefano Avenia, Sergio Galasse, Raffaele Farabi, Massimo Monacelli, Nicola Avenia
Format: Article
Language:English
Published: BMC 2019-04-01
Series:BMC Surgery
Subjects:
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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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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