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Role of frozen section associated with intraoperative cytology in comparison to FNA and FS alone in the management of thyroid nodules.
Eur J Surg Oncol. 2007 Aug; 33(6):769-75.EJ

Abstract

AIMS

The utilization of fine needle aspiration (FNA) biopsy is an accurate and cost-effective method in the diagnosis of thyroid diseases. However, the non-diagnostic cases and cases of suspicious carcinoma remain a dilemma, and in these cases thyroidectomy is usually recommended, even if only 15-20% of these patients really need a thyroidectomy. To avoid unnecessary surgical treatment, frozen section (FS) is usually performed. This method is well recognized, but is not useful for the diagnosis of follicular lesions. Therefore, many authors have tried to increase the specificity and sensibility of intraoperative examination, supporting it with an intraoperative cytological technique (IC). To clarify the role of intraoperative exam (FS and IC), also comparing to FNA, we have reviewed our own experiences.

METHODS

In a period covering 6 years (2000-2005), FS was performed in 1,472 cases out of 11,420 total thyroidectomy operations. FS diagnosis and definitive diagnosis, were reviewed and confirmed, moreover, FNA diagnosis and definitive diagnosis were also considered and all intraoperatory cytological slides were reviewed. Diagnostic accuracy was assessed for FNA and FS with or without intraoperative cytology. We compared 1,472 FS diagnoses with their definitive histological diagnosis; 728 FNA out of 1,472 patients with definitive histological diagnosis, and 564 FS associated with IC out of 1,472 patients with definitive diagnosis.

RESULTS

The diagnostic accuracy of these three methods were, respectively, 88.8%, 88.8% and 95.7%.

CONCLUSION

We can assert that FS associated with IC remains the most accurate technique in the surgical management of thyroid nodules.

Authors+Show Affiliations

Department of Surgery, Division of Pathology, University of Pisa, Via Roma 57, 56126, Pisa, Italy. f.basolo@med.unipi.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17223305

Citation

Basolo, F, et al. "Role of Frozen Section Associated With Intraoperative Cytology in Comparison to FNA and FS Alone in the Management of Thyroid Nodules." European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, vol. 33, no. 6, 2007, pp. 769-75.
Basolo F, Ugolini C, Proietti A, et al. Role of frozen section associated with intraoperative cytology in comparison to FNA and FS alone in the management of thyroid nodules. Eur J Surg Oncol. 2007;33(6):769-75.
Basolo, F., Ugolini, C., Proietti, A., Iacconi, P., Berti, P., & Miccoli, P. (2007). Role of frozen section associated with intraoperative cytology in comparison to FNA and FS alone in the management of thyroid nodules. European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 33(6), 769-75.
Basolo F, et al. Role of Frozen Section Associated With Intraoperative Cytology in Comparison to FNA and FS Alone in the Management of Thyroid Nodules. Eur J Surg Oncol. 2007;33(6):769-75. PubMed PMID: 17223305.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of frozen section associated with intraoperative cytology in comparison to FNA and FS alone in the management of thyroid nodules. AU - Basolo,F, AU - Ugolini,C, AU - Proietti,A, AU - Iacconi,P, AU - Berti,P, AU - Miccoli,P, Y1 - 2007/01/12/ PY - 2006/07/20/received PY - 2006/12/05/accepted PY - 2007/1/16/pubmed PY - 2007/9/28/medline PY - 2007/1/16/entrez SP - 769 EP - 75 JF - European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology JO - Eur J Surg Oncol VL - 33 IS - 6 N2 - AIMS: The utilization of fine needle aspiration (FNA) biopsy is an accurate and cost-effective method in the diagnosis of thyroid diseases. However, the non-diagnostic cases and cases of suspicious carcinoma remain a dilemma, and in these cases thyroidectomy is usually recommended, even if only 15-20% of these patients really need a thyroidectomy. To avoid unnecessary surgical treatment, frozen section (FS) is usually performed. This method is well recognized, but is not useful for the diagnosis of follicular lesions. Therefore, many authors have tried to increase the specificity and sensibility of intraoperative examination, supporting it with an intraoperative cytological technique (IC). To clarify the role of intraoperative exam (FS and IC), also comparing to FNA, we have reviewed our own experiences. METHODS: In a period covering 6 years (2000-2005), FS was performed in 1,472 cases out of 11,420 total thyroidectomy operations. FS diagnosis and definitive diagnosis, were reviewed and confirmed, moreover, FNA diagnosis and definitive diagnosis were also considered and all intraoperatory cytological slides were reviewed. Diagnostic accuracy was assessed for FNA and FS with or without intraoperative cytology. We compared 1,472 FS diagnoses with their definitive histological diagnosis; 728 FNA out of 1,472 patients with definitive histological diagnosis, and 564 FS associated with IC out of 1,472 patients with definitive diagnosis. RESULTS: The diagnostic accuracy of these three methods were, respectively, 88.8%, 88.8% and 95.7%. CONCLUSION: We can assert that FS associated with IC remains the most accurate technique in the surgical management of thyroid nodules. SN - 0748-7983 UR - https://www.unboundmedicine.com/medline/citation/17223305/Role_of_frozen_section_associated_with_intraoperative_cytology_in_comparison_to_FNA_and_FS_alone_in_the_management_of_thyroid_nodules_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0748-7983(06)00489-6 DB - PRIME DP - Unbound Medicine ER -