Journal article
ATA risk stratification in papillary thyroid microcarcinoma has low positive predictive value when identifying recurrence
The American journal of surgery, Vol.229, pp.106-110
03/2024
DOI: 10.1016/j.amjsurg.2023.11.003
PMID: 37968147
Abstract
Background
Rising incidence of papillary thyroid microcarcinomas (PTMC) has raised concerns for overdiagnosis. Utility of the American Thyroid Association Risk Stratification System (ATA-RSS) 2015 in predicting risk of disease recurrence in patients with PTMC was assessed.
Methods
Electronic health records of patients who underwent total thyroidectomy were queried. ATA-RSS 2015 risk stratification was performed on those with PTMC, and validity for predicting disease recurrence was calculated.
Results
With 10-year median follow up, recurrence was higher in PTMC patients with high/intermediate vs low ATA risk (33 % vs 4 %, p = 0.002). Sensitivity of ATA-RSS for detecting recurrence was 60 %, specificity 90 %, PPV 33.3 %, NPV 96.6 %, and accuracy 88 %. When microscopic extrathyroidal extension (ETE) was excluded as an intermediate risk criterion, PPV improved to 50 % and accuracy improved to 92.5 %
Conclusions
ATA-RSS 2015 predicts recurrence in PTMC with high NPV but low PPV. Exclusion of microscopic ETE improved PPV, which may help prevent overtreatment.
Details
- Title: Subtitle
- ATA risk stratification in papillary thyroid microcarcinoma has low positive predictive value when identifying recurrence
- Creators
- Andy Tran - University of IowaRonald J. Weigel - University of Iowa Hospitals and ClinicsAnna C. Beck - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The American journal of surgery, Vol.229, pp.106-110
- DOI
- 10.1016/j.amjsurg.2023.11.003
- PMID
- 37968147
- NLM abbreviation
- Am J Surg
- ISSN
- 0002-9610
- eISSN
- 1879-1883
- Language
- English
- Electronic publication date
- 11/2023
- Date published
- 03/2024
- Academic Unit
- Molecular Physiology and Biophysics; Anatomy and Cell Biology; Surgery; Biochemistry and Molecular Biology
- Record Identifier
- 9984507027302771
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