title: Risk Stratification of Neck Lesions Detected Sonographically During the Follow-Up of Differentiated Thyroid Cancer.
abstract: The European Thyroid Association (ETA) has classified posttreatment cervical ultrasound findings in thyroid cancer patients based on their association with disease persistence/recurrence.
  
  
  
  The objective of the study was to assess this classification's ability to predict the growth and persistence of such lesions during active posttreatment surveillance of patients with differentiated thyroid cancer (DTC).
  
  
  
  This was a retrospective, observational study.
  
  
  
  The study was conducted at a thyroid cancer center in a large Italian teaching hospital.
  
  
  
  Center referrals (2005-2014) were reviewed and patients selected with pathologically-confirmed DTC; total thyroidectomy, with or without neck dissection and/or radioiodine remnant ablation; abnormal findings on two or more consecutive posttreatment neck sonograms; and subsequent follow-up consisting of active surveillance. Baseline ultrasound abnormalities (thyroid bed masses, lymph nodes) were classified according to the ETA system. Patients were divided into group S (those with one or more lesions classified as suspicious) and group I (indeterminate lesions only). We recorded baseline and follow-up clinical data through June 30, 2015.
  
  
  
  The main outcomes were patients with growth (>3 mm, largest diameter) of one or more lesions during follow-up and patients with one or more persistent lesions at the final visit.
  
  
  
  The cohort included 58 of the 637 DTC cases screened (9%). A total of 113 lesions were followed up (18 thyroid bed masses, 95 lymph nodes). During surveillance (median 3.7 y), group I had significantly lower rates than group S of lesion growth (8% vs 36%, P = .01) and persistence (64% vs 97%, P = .014). The median time to scan normalization was 2.9 years.
  
  
  
  The ETA's evidence-based classification of sonographically detected neck abnormalities can help identify papillary thyroid cancer patients eligible for more relaxed follow-up.
authors.affiliation: Dipartimento di Medicina Interna e Specialità Mediche (L.L., G.G., S.L., M.M., K.P., M.S., F.T., A.V., S.F., C.D.), Dipartimento di Scienze Chirurgiche (M.B., L.G.), Università di Roma "Sapienza," 00161 Roma, Italy; and Department of Internal Medicine (G.C.), Institut Jules Bordet Comprehensive Cancer Center, 1000 Brussels, Belgium.
authors.forename: Livia
authors.initials: L
authors.lastname: Lamartina
authors.affiliation: Dipartimento di Medicina Interna e Specialità Mediche (L.L., G.G., S.L., M.M., K.P., M.S., F.T., A.V., S.F., C.D.), Dipartimento di Scienze Chirurgiche (M.B., L.G.), Università di Roma "Sapienza," 00161 Roma, Italy; and Department of Internal Medicine (G.C.), Institut Jules Bordet Comprehensive Cancer Center, 1000 Brussels, Belgium.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Grani
authors.affiliation: Dipartimento di Medicina Interna e Specialità Mediche (L.L., G.G., S.L., M.M., K.P., M.S., F.T., A.V., S.F., C.D.), Dipartimento di Scienze Chirurgiche (M.B., L.G.), Università di Roma "Sapienza," 00161 Roma, Italy; and Department of Internal Medicine (G.C.), Institut Jules Bordet Comprehensive Cancer Center, 1000 Brussels, Belgium.
authors.forename: Marco
authors.initials: M
authors.lastname: Biffoni
authors.affiliation: Dipartimento di Medicina Interna e Specialità Mediche (L.L., G.G., S.L., M.M., K.P., M.S., F.T., A.V., S.F., C.D.), Dipartimento di Scienze Chirurgiche (M.B., L.G.), Università di Roma "Sapienza," 00161 Roma, Italy; and Department of Internal Medicine (G.C.), Institut Jules Bordet Comprehensive Cancer Center, 1000 Brussels, Belgium.
authors.forename: Laura
authors.initials: L
authors.lastname: Giacomelli
authors.affiliation: Dipartimento di Medicina Interna e Specialità Mediche (L.L., G.G., S.L., M.M., K.P., M.S., F.T., A.V., S.F., C.D.), Dipartimento di Scienze Chirurgiche (M.B., L.G.), Università di Roma "Sapienza," 00161 Roma, Italy; and Department of Internal Medicine (G.C.), Institut Jules Bordet Comprehensive Cancer Center, 1000 Brussels, Belgium.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Costante
authors.affiliation: Dipartimento di Medicina Interna e Specialità Mediche (L.L., G.G., S.L., M.M., K.P., M.S., F.T., A.V., S.F., C.D.), Dipartimento di Scienze Chirurgiche (M.B., L.G.), Università di Roma "Sapienza," 00161 Roma, Italy; and Department of Internal Medicine (G.C.), Institut Jules Bordet Comprehensive Cancer Center, 1000 Brussels, Belgium.
authors.forename: Stefania
authors.initials: S
authors.lastname: Lupo
authors.affiliation: Dipartimento di Medicina Interna e Specialità Mediche (L.L., G.G., S.L., M.M., K.P., M.S., F.T., A.V., S.F., C.D.), Dipartimento di Scienze Chirurgiche (M.B., L.G.), Università di Roma "Sapienza," 00161 Roma, Italy; and Department of Internal Medicine (G.C.), Institut Jules Bordet Comprehensive Cancer Center, 1000 Brussels, Belgium.
authors.forename: Marianna
authors.initials: M
authors.lastname: Maranghi
authors.affiliation: Dipartimento di Medicina Interna e Specialità Mediche (L.L., G.G., S.L., M.M., K.P., M.S., F.T., A.V., S.F., C.D.), Dipartimento di Scienze Chirurgiche (M.B., L.G.), Università di Roma "Sapienza," 00161 Roma, Italy; and Department of Internal Medicine (G.C.), Institut Jules Bordet Comprehensive Cancer Center, 1000 Brussels, Belgium.
authors.forename: Katia
authors.initials: K
authors.lastname: Plasmati
authors.affiliation: Dipartimento di Medicina Interna e Specialità Mediche (L.L., G.G., S.L., M.M., K.P., M.S., F.T., A.V., S.F., C.D.), Dipartimento di Scienze Chirurgiche (M.B., L.G.), Università di Roma "Sapienza," 00161 Roma, Italy; and Department of Internal Medicine (G.C.), Institut Jules Bordet Comprehensive Cancer Center, 1000 Brussels, Belgium.
authors.forename: Marialuisa
authors.initials: M
authors.lastname: Sponziello
authors.affiliation: Dipartimento di Medicina Interna e Specialità Mediche (L.L., G.G., S.L., M.M., K.P., M.S., F.T., A.V., S.F., C.D.), Dipartimento di Scienze Chirurgiche (M.B., L.G.), Università di Roma "Sapienza," 00161 Roma, Italy; and Department of Internal Medicine (G.C.), Institut Jules Bordet Comprehensive Cancer Center, 1000 Brussels, Belgium.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Trulli
authors.affiliation: Dipartimento di Medicina Interna e Specialità Mediche (L.L., G.G., S.L., M.M., K.P., M.S., F.T., A.V., S.F., C.D.), Dipartimento di Scienze Chirurgiche (M.B., L.G.), Università di Roma "Sapienza," 00161 Roma, Italy; and Department of Internal Medicine (G.C.), Institut Jules Bordet Comprehensive Cancer Center, 1000 Brussels, Belgium.
authors.forename: Antonella
authors.initials: A
authors.lastname: Verrienti
authors.affiliation: Dipartimento di Medicina Interna e Specialità Mediche (L.L., G.G., S.L., M.M., K.P., M.S., F.T., A.V., S.F., C.D.), Dipartimento di Scienze Chirurgiche (M.B., L.G.), Università di Roma "Sapienza," 00161 Roma, Italy; and Department of Internal Medicine (G.C.), Institut Jules Bordet Comprehensive Cancer Center, 1000 Brussels, Belgium.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Filetti
authors.affiliation: Dipartimento di Medicina Interna e Specialità Mediche (L.L., G.G., S.L., M.M., K.P., M.S., F.T., A.V., S.F., C.D.), Dipartimento di Scienze Chirurgiche (M.B., L.G.), Università di Roma "Sapienza," 00161 Roma, Italy; and Department of Internal Medicine (G.C.), Institut Jules Bordet Comprehensive Cancer Center, 1000 Brussels, Belgium.
authors.forename: Cosimo
authors.initials: C
authors.lastname: Durante
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D002291:Carcinoma, Papillary; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D009333:Neck / Q000000981:diagnostic imaging*; D037981:Neck Dissection; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D020379:Risk Adjustment; D012307:Risk Factors; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult