Improving the TIR3B oncological stratification: try to bridge the gap through a comprehensive presurgical algorithm

Purpose Indeterminate cytology still puzzles clinicians, due to its wide range of oncological risks. According to the Italian SIAPEC–IAP classification, TIR3B cytology holds up to 30% of thyroid cancer, which justifies the surgical indication, even if more than half of cases do not result in a posit...

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Bibliographic Details
Published in:Journal of endocrinological investigation 2024-03, Vol.47 (3), p.633-643
Main Authors: Sparano, C., Puccioni, M., Adornato, V., Zago, E., Fibbi, B., Badii, B., Bencini, L., Mannelli, G., Vezzosi, V., Maggi, M., Petrone, L.
Format: Article
Language:English
Subjects:
Algorithms
Cellular biology
Cytology
Endocrinology
Hospitals
Humans
Internal Medicine
Medical Oncology
Medicine
Medicine & Public Health
Metabolic Diseases
Nodules
Original Article
Retrospective Studies
Surgery
Thyroid cancer
Thyroid Neoplasms
Ultrasonic imaging
Ultrasound
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Summary:Purpose Indeterminate cytology still puzzles clinicians, due to its wide range of oncological risks. According to the Italian SIAPEC–IAP classification, TIR3B cytology holds up to 30% of thyroid cancer, which justifies the surgical indication, even if more than half of cases do not result in a positive histology. The study aim is to identify potential clinical, ultrasound or cytological features able to improve the surgical indication. Methods Retrospective analysis. A consecutive series of TIR3B nodules referred to the Endocrine Unit of Careggi Hospital from 1st May 2014 to 31st December 2021 was considered for the exploratory analysis (Phase 1). Thereafter, a smaller confirmatory sample of consecutive TIR3B diagnosed and referred to surgery from 1st January 2022 to 31st June 2022 was considered to verify the algorithm (Phase 2). The main clinical, ultrasound and cytological features have been collected. A comprehensive stepwise logistic regression was applied to build a prediction algorithm. The histological results represented the final outcome. Results Of 599 TIR3B nodules referred to surgery, 451 cases were included in the exploratory analysis. A final score > 14.5 corresponded to an OR = 4.98 (95% CI 3.24–7.65, p  
ISSN:1720-8386
0391-4097
1720-8386
DOI:10.1007/s40618-023-02182-5