Thyroid cancer has received much recent press coverage after an article in the medical journal JAMA Oncology described the work of an international group of thyroid pathologists and clinical experts. This international collaboration looked at the terminology for one subtype of thyroid cancer, the ‘non-invasive encapsulated follicular variant of papillary thyroid carcinoma’. The authors confirmed that this particular tumour is likely to behave in a non-aggressive fashion and proposed a new name to reflect this - ‘non-invasive follicular thyroid neoplasm with papillary-like nuclei (NIFTP)’.
The UK Endocrine Pathology Society (UKEPS), a group of British pathologists with an interest in the pathology of thyroid disease and thyroid cancer, has discussed this development. The UKEPS agrees that this is a very positive step for patients, because the article confirms what was already suspected which is that this particular subtype of tumour has a very good prognosis.
It is important for patients and their doctors to recognise that this new tumour classification does not apply to all thyroid cancers, but only to one very carefully defined subtype which accounts for one tenth to one fifth of all existing thyroid cancers. There are many different types of thyroid cancer, only one of which is the encapsulated follicular variant of papillary thyroid carcinoma. These tumours can be invasive or non-invasive. It is imperative that the new NIFTP terminology is only used for those non-invasive encapsulated follicular variants of papillary carcinoma, when the published pathological criteria are fulfilled.
Patients also need to know that pathologists in the UK have been aware of and have reported non-invasive encapsulated follicular variant of papillary carcinoma for many years. It was already well known that these tumours behave in a low risk fashion and this is clearly recognised in the way these tumours have been treated in the past and are currently being treated in the UK. The new NIFTP terminology does not alter this, it just changes the name.
At this interim stage until NIFTP is fully established and pending publication in 2017 of the fourth edition of the WHO Blue Book ‘Pathology and Genetics of Tumours of Endocrine Organs’, the UK Endocrine Pathology Society currently recommends that, when the criteria for NIFTP are met,BOTH names are given in the report. Examples of phrasing could be ‘non-invasive encapsulated follicular variant of papillary carcinomaalso now referred to as NIFTP’ or “NIFTP, formerly known as non-invasive encapsulated follicular variant of papillary carcinoma’ so that patients and doctors treating them are aware of the terminology.
10th May 2016