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Special Issue Editors

Prof. Dr. Claudio Spinelli

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Guest Editor

Division of Pediatric Surgery, Department of Surgical Pathology, University of Pisa, 56126 Pisa, Italy
Interests: endocrine surgery; pediatric surgery; oncologic surgery

Dr. Marco Ghionzoli

E-Mail Website
Guest Editor

Division of Pediatric Surgery, Department of Surgical Pathology, University of Pisa, 56126 Pisa, Italy
Interests: pediatric surgery

Special Issue Information

Dear Colleagues,

As is already known, thyroid nodules usually occur in the general population and differentiating between benign and malignant ones is still a challenge. The basic tests for the risk stratification of thyroid nodules comprise serum TSH, ultrasonography (US), and fine-needle aspiration (FNA), which are the baseline in general practice, with radionuclide scans performed only for patients with low TSH. Assessing the risk of malignancy of thyroid nodules with US is crucial, as it can support in the selection of those who should undergo fine-needle aspiration (FNA) and subsequent surgery. Several reports identified a few US features that are remarkably more frequent in malignant thyroid nodules, which can be merged to be used as indicators of high risk.

Moreover, the global trend towards customized treatments for any patient warrant that any surgical strategy should take into account tumor-associated biological features and associated syndromes (e.g., APC-associated polyposis, Carney complex, DICER1 syndrome, PTEN hamartoma tumor syndrome).

As pediatric surgeons, huge effort has been made to understand how age is a crucial factor in patient outcome: while thyroid nodules are much more common in adults, they are much more likely to be malignant in children, resulting in a better outcome. Guidelines for the assessment and management of pediatric thyroid nodules have historically been extrapolated from recommendations for adults: a standardized therapeutic approach could be considered an overtreatment for a child; for this reason, recently, specific pediatric guidelines have been published.

Prof. Dr. Claudio Spinelli
Dr. Marco Ghionzoli
Guest Editors

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Keywords

thyroid nodule
thyroid cancer
guidelines
surgery

Published Papers (1 paper)

Research

18 pages, 1839 KiB

Open AccessArticle

The Incidence Trend and Management of Thyroid Cancer—What Has Changed in the Past Years: Own Experience and Literature Review

by Krzysztof Kaliszewski, Dorota Diakowska, Michał Miciak, Krzysztof Jurkiewicz, Michał Kisiel, Szymon Makles, Anna Dziekiewicz, Szymon Biernat, Maksymilian Ludwig, Bartłomiej Ludwig, Karolina Sutkowska-Stępień, Maciej Sebastian, Paweł Domosławski, Krzysztof Sutkowski and Beata Wojtczak

Cancers 2023, 15(20), 4941; https://doi.org/10.3390/cancers15204941 - 11 Oct 2023

Viewed by 1027

Abstract

Because of ambiguous and widely debated observations concerning the incidence, trend, and management of TC, we performed this analysis. We drew attention to some events, such as “cancer screening activity”, introduction of noninvasive follicular neoplasm with papillary-like nuclear features (NIFTP) to TC types, possibility of papillary thyroid microcarcinoma (PTMC) active surveillance (AS), occurrence of personalized medicine in TC management, and, finally, COVID-19 pandemic time. Because of the opinion that all changes have been made mostly by PTC, we compared it to the remaining types of TC in terms of incidence, clinical and pathological characteristics, and treatment. We analyzed patients treated in a single surgical center in eastern Europe (Poland). The prevalence of TC significantly increased from 5.15% in 2008 to 13.84% in 2015, and then significantly decreased to 1.33% in 2022 when the COVID-19 pandemic lasted (p < 0.0001). A similar trend was observed for PTC, when the incidence significantly increased to 13.99% in 2015 and then decreased to 1.38% in 2022 (p < 0.0001). At that time, the NIFTP category was introduced, and observation of PTMC began. The prevalence of FTC and MTC also increased until 2015 and then decreased. Significant differences in age, types of surgery, necessity of reoperation, and pTNM between PTCs and other types of TCs were observed. The average age was significantly lower in PTC patients than in patients with the remaining types of TC (p < 0.0001). Four milestones, including NIFTP introduction, the possibility of PTMC AS, personalized cancer medicine, and the COVID-19 pandemic, may have influenced the general statistics of TC. Full article

(This article belongs to the Special Issue Classification, Risk Assessment and Clinical Management of Malignant Thyroid Nodules)

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