Recommended Surgery for >1 cm Noninvasive Follicular Neoplasia with Papillary-Like Nuclear Features (NIFTP)

Papillary thyroid carcinoma (PTC) is a heterogeneous tumor group with differing pathogenesis and prognosis of the individual subtypes. In addition, a tumor entity has been spun off, now referred to as “noninvasive follicular neoplasm with papillary-like nuclear features (NIFTP). A recent study, based on a comprehensive evaluation of a prospective multicenter NIFTP-based retrospective study, was intended to clarify whether NIFTP can metastasize and thus justify a reduced resection rate compared to classical PTC. For 3 reasons, Authors nicely recommend caution regarding a limited thyroid procedure (i.e. lobectomy vs. completion thyroidectomy): i) In the current literature, lymph node metastases have been described in 10 patients with NIFTP, and in 1 patient lung metastases. ii) As reported for the first time in this study, nearly one-fifth of patients have NIFTP-associated PTMC with unclear potential for metastasis. iii) Observation periods are still relatively short and so far, there are no agreed follow-up standards.