Recurrence Risk Assessment of Papillary Thyroid Carcinoma According to Pre-surgery FNAC Category

"Recurrence risk assessment of papillary thyroid carcinoma according to presurgery FNAC category".

This study investigates the prognostic value of presurgical fine-needle aspiration cytology (FNAC) categories (TIR3B, TIR4, TIR5) in papillary thyroid carcinoma (PTC), analyzing 159 nodules from high-volume (HV) and low-volume (LV) institutions. Higher FNAC categories (TIR4/5) correlated with aggressive histological features, including larger tumor size, lymph node metastasis, peri-thyroid invasion (25% vs. 50.7%, *p*=0.02), and elevated ATA recurrence risk (low-risk: 81.3% in TIR3B vs. 45.3% in TIR5, *p*=0.008). TIR3B PTCs exhibited indolent behavior, with predominant follicular subtypes (78.1%) and lower surgical invasiveness. Despite differences in FNAC distribution (TIR3B more frequent in LV centers, *p*=0.01), recurrence risk trends remained consistent across institutional volumes. 

The findings underscore FNAC's role in preoperative risk stratification, supporting tailored management to reduce overtreatment. 

Limitations include retrospective design and potential surgical bias. Validation in larger cohorts is recommended to reinforce clinical applicability... .Updates in Surgery, Springer. doi.org/10.1007/s13304-025-02121-4. Published online: 26 February 2025.