Discussing the Reclassification of NIFTP

Yuri E. Nikiforov, MD, PhD, professor of pathology and director of the Division of Molecular Anatomic Pathology at the University of Pittsburgh School of Medicine, discusses the reclassification of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP), which has significantly influenced the thyroid cancer space.

Prior to 2016, the tumor, an encapsulated follicular variant of papillary thyroid cancer (EFVPTC), used to be called a type of cancer. Patients with EFVPTC were typically treated with thyroidectomy or radiation, conventional thyroid cancer treatments. However, researchers found these tumors to be low-risk and deemed lobectomy to be a usually sufficient treatment.

As a result, investigators conducted an international, multidisciplinary, retrospective study to further evaluate the tumor type. The panel of the study concluded that this type of tumor was indolent and ended up renaming the tumor, NIFTP.

Transcription

0:08 | The reclassification happened in 2016. It was preceded by about 2 years of work of the international groups that I had privileged to organize and lead. The reason for a classification was that we knew for many years that there is a group or a type of thyroid cancer that is extremely indolent. The patients do very well, and patients don't die of this disease. Yet, we were diagnosing it at an increasing rate. Patients were treated very aggressively. They were treated with the removal of the thyroid and given radioactive iodine. We felt that this is an overtreatment for these patients.

1:00 | So the international group of physicians got together and looked at all of the available information, and based on the data, it offered this data-driven reclassification of this cancer, and removed the word cancer, and called them as a non-cancerous or NIFTP. That in essence was needed in the field, and that was why this happened in 2016.