Anzeige
Erschienen in:
26.09.2023 | Endocrine Tumors
Letter to the Editor in Response to the Article Entitled “Selection Criteria for Completion Thyroidectomy in Follicular Thyroid Carcinoma Using Primary Tumor Size and TERT Promotor Mutational Status”
Erschienen in: Annals of Surgical Oncology | Ausgabe 13/2023
Einloggen, um Zugang zu erhaltenExcerpt
We discussed the article “Selection Criteria for Completion Thyroidectomy in Follicular Thyroid Carcinoma Using Primary Tumor Size and TERT Promotor Mutational Status” by Park et al. in our department journal club.1 We congratulate the authors on their study on how both size and TERT promotor mutational status can guide us when deciding on the management of follicular thyroid carcinoma (FTC) after lobectomy. This type of study can really help when deciding surgical management in grey areas such as minimally invasive FTC/encapsulated angioinvasive FTC (MIFTC/EAFTC) 2–4 cm in size. American Thyroid Association guidelines recommend completion thyroidectomy for patients with tumor size > 4 cm, gross extrathyroidal extension, presence of node metastasis, presence of initial distant metastasis, and EAFTC.2 This was a unique study determining the role of TERT mutational status in FTC patients, as opposed to previous studies that reported on papillary thyroid cancer.3 This study is likely to have implications in day-to-day clinical practice in the context of the management of FTC patients; however, we have a few queries and comments as follows:-
In the present study, was there any selection criteria for patients who undergo TERT promotor mutation testing? Furthermore, it is not clear whether the mutation testing was performed prior to or after the patient had undergone lobectomy. In case the results were available prior to surgery, would a decision for primary total thyroidectomy be taken?
-
Did the author find that TERT mutation status was an independent prognostic factor on multivariate analysis?
-
We would also like to know the authors’ view on the cost effectivity of TERT mutational testing.