; 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
Differentiated thyroid cancer (DTC) profile has changed over the last decades.
To describe the pathologic characteristics of DTC at the time of primary treatment in a large contemporary series.
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.
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.
Early-stage and low-risk DTC prevails in contemporary Italian series.