It’s not cancer: doctors reclassify a thyroid tumor
Nomenclature revision for encapsulated follicular variant of papillary thyroid carcinoma
A paradigm shift to reduce overtreatment of indolent tumors
Yuri E. Nikiforov et al.
JAMA Oncol. 2016;2(8):1023-1029. doi:10.1001/jamaoncol.2016.0386
Their conclusion, and the data that led to it, was reported in the journal JAMA Oncology. The change is expected to affect about 10,000 of the nearly 65,000 thyroid cancer patients a year in the United States. It may also offer grist to those who have been arguing for the reclassification of some other forms of cancer, including certain lesions in the breast and prostate.
The reclassified tumor is a small lump in the thyroid that is completely surrounded by a capsule of fibrous tissue. Its nucleus looks like a cancer but the cells have not broken out of their capsule, and surgery to remove the entire thyroid followed by treatment with radioactive iodine is unnecessary and harmful, the panel said.
They have now renamed the tumor. Instead of calling it ‘encapsulated follicular variant of papillary thyroid carcinoma’ or EFVPTC, they now call it ‘noninvasive follicular thyroid neoplasm with papillary-like nuclear features’ or NIFTP. The word carcinoma is gone.
Although growing evidence points to highly indolent behavior of encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC), most patients with EFVPTC are treated as having conventional thyroid cancer.