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Non invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFT-P). A clinic evaluation of novel nomenclature.

AIM
We aimed to find out unnecessarily overdiagnosed and overtreated patients, their preventable morbidities, expenditures which might not have occurred in the last decade concerning newly proposed nomenclature MATERIAL AND METHODS: Among 1553 patients operated between 2010-2019, 197 were recorded. Pathology specimens were re-evaluated by two experienced pathologists to reveal those patients who could have diagnosed as NIFT-P.


RESULTS
According to the changes first suggested by Nikiforov in 2016 and partially revised in 2018; 55 of 197 patients were diagnosed with NIFT-P. Four (7,2%) patients had NIFT-P (operated after 2016), 14 patients (25.5%) had follicular adenoma, 13 patients (23.6%) had unknown malign potential, five patients (9.1%) had papillary microcarcinoma, two patients (3.6%) had papillary microcarcinoma encapsulated, five patients (9.1%) had papillary carcinoma follicular and two patients (3.6%) had papillary carcinoma encapsulated. 40 patients (72.7%) underwent thyroidectomy (bilateral total), 12 patients (21.8%) thyroidectomy (lobectomy, unilateral), two patients (3.6%) thyroidectomy (completion, total) and one patient (1.8%) neck dissection + thyroidectomy (bilateral, total).


DISCUSSION
The follicular variant of the papillary thyroid carcinoma was re-defined with a novel nomenclature as a noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFT-P) according to its indolent behavior that did not require aggressive treatment,so lobectomy is sufficient, was suggested in 2016.


CONCLUSIONS
We found out that if we hadn't applied thyroidectomy (total or completion) to those 43 patients concerning new nomenclature, we could have prevented complications (2 patients, %3,6) and cut down the expenses caused by overtreatment in the last decade. NIFT-P has an excellent prognosis for its low locoregional or distant recurrence, so lobectomy is sufficient.


KEY WORDS
Bethesda, NIFT-P, Total Thyroidectomy, Complication.