Durante, Cosimo1; Lamartina, Livia1; Lucisano, Giuseppe2; Grani, Giorgio1; Nicolucci, Antonio2; Arvat, Emanuela3; Lombardi, Celestino Pio4; Orlandi, Fabio5; Pontecorvi, Alfredo4; Torlontano, Massimo6; Zatelli, Maria Chiara7; Tallini, Giovanni8; Puxeddu, Efisio9; Filetti, Sebastiano1
1 Department of Internal Medicine and Medical Specialties, University “Sapienza”, Rome
2 Center for Outcomes Research and Clinical Epidemiology, Pescara
3 Department of Medical Sciences, University of Turin, Turin
4 University Hospital Agostino Gemelli, Catholic University of the Sacred Heart, Rome
5 Department of Oncology, Gradenigo Hospital, University of Turin, Turin
6 Endocrinology Unit, Casa Sollievo della Sofferenza, San Giovanni Rotondo
7 Department of Medical Science, Section of Endocrinology and Internal Medicine, University of Ferrara, Ferrara
8 Department of Medicine, University of Bologna, Anatomic Pathology, Ospedale Bellaria, Bologna
9 Department of Medicine, University of Perugia, Perugia
Background: Differentiated thyroid cancer (DTC) profile has changed over the last decades.
Purpose: To describe the pathologic characteristics of DTC at the time of primary treatment in a large contemporary series.
Methods: The Italian Thyroid Cancer Observatory set-up a prospective, web-based observational study collecting data on newly diagnosed DTC patients from 32 Italian centers (start date: 2013). Tumors were classified at the time of primary treatment according to AJCC/TNM staging 7th edition and American Thyroid Association (ATA) risk stratification.
Results: 2019 consecutive patients (76.6% females, median age 48.7 years) were collected. Total thyroidectomy was performed in 97.6% of the patients, 59.9% underwent radioiodine remnant ablation. DTC histology was papillary in 92%, follicular in 6%, and other variants in 2% of the cases. Tumors were classified as T1a, T1b, T2 and T3-intrathyroidal in 783 (39%), 389 (19%), 228 (11%) and 51 (2.5%) of the cases. Microscopic (T3) or macroscopic (T4) extrathyroidal extension was observed in 504 (25%) and 64 (3%) patients. Lymph node metastases were classified as N1a in 244 (12%) and N1b in 177 (8.8%) cases. The 1205 patients aged ?45 were: 646 (53.6%) Stage I, 105 (8.8%) Stage II, 346 (28.7%) Stage III, 73 (6.1%) Stage IVa, 2 (0.1%) Stage IVb and 33 (2.7%) Stage IVc. The 814 patients aged <45 yrs were Stage II in 14 (1.7%) cases. ATA risk of recurrence was low in 1161 (58%), intermediate in 723 (36%) and high in 135 (6%) patients.
Discussion&Conclusion: Early-stage and low-risk DTC prevails in contemporary Italian series.