{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T08:14:48Z","timestamp":1769069688858,"version":"3.49.0"},"reference-count":48,"publisher":"Royal College of Surgeons of England","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p> The purpose of this study was to evaluate the incidence of incidental differentiated thyroid carcinoma in thyroid operations for a benign preoperative diagnosis, to identify the risk factors involved and to risk stratify the cancer patients according to the 2015 American Thyroid Association (ATA) guidelines. <\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p> The study was a retrospective review of all thyroidectomy operations performed in a single institution (January 2004 to January 2009). We excluded patients with a preoperative diagnosis of thyroid malignancy. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Incidental differentiated thyroid carcinoma was diagnosed in 282\/1369 patients (21%). The incidental group had a significantly higher number of males (19% vs 14%, P = 0.033) and a higher number of patients with histopathological evidence of thyroiditis (35% vs 25%, P = 0.004). There was a higher number of lymph nodes present in the incidental group but numbers did not reach statistical significance (17% vs 13%, P = 0.079). There were 270 cases in the ATA low-risk group (96%) and 12 cases in the ATA intermediate-risk group (4%). Patients with an ATA intermediate risk had a statistically higher number of capsule invasion, extrathyroidal extension and angioinvasion (P &lt; 0.001, P &lt; 0.001 and P &lt; 0.001, respectively). Overall, 22% of patients with an incidental differentiated thyroid carcinoma should be considered for radioactive iodine 131I treatment. 29 of the 191 patients in American Joint Committee on Cancer stage I should be considered for radioactive iodine treatment (15%). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> Males and patients with thyroiditis are at a higher risk for an incidental differentiated thyroid carcinoma. One of every five of patients diagnosed with cancer will need radioactive iodine treatment, even some patients with stage I disease. <\/jats:p><\/jats:sec>","DOI":"10.1308\/rcsann.2018.0017","type":"journal-article","created":{"date-parts":[[2018,2,27]],"date-time":"2018-02-27T10:18:30Z","timestamp":1519726710000},"page":"357-365","source":"Crossref","is-referenced-by-count":7,"title":["Risk stratification of 282 differentiated thyroid cancers found incidentally in 1369 total thyroidectomies according to the 2015 ATA guidelines; implications for management and treatment"],"prefix":"10.1308","volume":"100","author":[{"given":"I","family":"Christakis","sequence":"first","affiliation":[{"name":"Department of Endocrine Surgery, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Dimas","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Mediterraneo Hospital, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ID","family":"Kafetzis","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Errikos Dunant Hospital Center, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N","family":"Roukounakis","sequence":"additional","affiliation":[{"name":"First Department of General Surgery and Transplantation, \u2018Evangelismos\u2018 General Hospital, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"171","reference":[{"key":"bib1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-69-3-537"},{"key":"bib2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1977.tb01340.x"},{"key":"bib3","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0530"},{"key":"bib4","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2010.0417"},{"key":"bib5","doi-asserted-by":"publisher","DOI":"10.1053\/beem.2000.0109"},{"issue":"9","key":"bib6","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/j.endonu.2016.05.009","volume":"63","author":"Gonzalez-Sanchez-Migallon E","year":"2016","journal-title":"Endocrinol Nutr"},{"key":"bib7","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"bib8","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPPHLWMI3JV4LA"},{"key":"bib9","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-010-0985-4"},{"issue":"1","key":"bib10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/cen.12477","volume":"81","author":"British Thyroid Association","year":"2014","journal-title":"Clin Endocrinol"},{"key":"bib11","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-08-0960"},{"key":"bib12","doi-asserted-by":"publisher","DOI":"10.1054\/bjoc.2001.2061"},{"key":"bib13","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2004.14.1056"},{"key":"bib14","volume-title":"Pathology and Genetics: Tumours of Endocrine Organs. 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