ATA risk stratification in papillary thyroid microcarcinoma has low positive predictive value when identifying recurrence

Andy Tran; Ronald J. Weigel; Anna C. Beck

doi:10.1016/j.amjsurg.2023.11.003

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ATA risk stratification in papillary thyroid microcarcinoma has low positive predictive value when identifying recurrence

Journal article

Peer reviewed

ATA risk stratification in papillary thyroid microcarcinoma has low positive predictive value when identifying recurrence

Andy Tran, Ronald J. Weigel and Anna C. Beck

The American journal of surgery, Vol.229, pp.106-110

03/2024

DOI: 10.1016/j.amjsurg.2023.11.003

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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 Iowa
Ronald J. Weigel - University of Iowa Hospitals and Clinics
Anna 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
ISSN: 0002-9610
eISSN: 1879-1883
Language: English
Electronic publication date: 11/2023
Date published: 03/2024
Academic Unit: Biochemistry and Molecular Biology; Molecular Physiology and Biophysics; Anatomy and Cell Biology; Surgery
Record Identifier: 9984507027302771

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