Current controversies in the management of patients with indeterminate thyroid nodules

Alqahtani, Saad M

doi:10.15537/smj.2023.44.7.2023-0049

Cited by 3 publications

(9 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The first step in the evaluation of TNs includes physical examination and the collection of the patient’s history. This is followed by neck US with or without fine needle aspiration (FNA) ( 1 ).…”

Section: Introductionmentioning

confidence: 99%

“…US characterizes the nodules in terms of size, echogenicity, echotexture, composition, margins, calcification, shape, and lymph node status. Furthermore, it aids in risk stratification of TNs and, as a result, determines the necessity for FNA ( 1 ). The sensitivity of FNA has been reported to vary between 80% and 94%, whereas false negative rates range from 1.9% to 12.7% across different institutions.…”

Section: Introductionmentioning

confidence: 99%

“…However, approximately 25% of all FNAs have uncertain cytology, and these are referred to as indeterminate TNs (ITNs). Surprisingly, these tend to be clinically challenging ( 1 ). Repeat FNA, molecular testing, or diagnostic thyroid lobectomy (TL) are recommended to exclude malignancy in ITNs ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…Repeat FNA, molecular testing, or diagnostic thyroid lobectomy (TL) are recommended to exclude malignancy in ITNs ( 3 ). Of note, 70–80% of ITNs exhibit benign histology after thyroidectomy, suggesting unnecessary diagnostic procedures ( 1 , 4 ).…”

Section: Introductionmentioning

confidence: 99%

“…Currently, no established criteria can effectively differentiate between malignant and benign lesions in the context of ITNs ( 1 ). Over the last decade, numerous diagnostic tools, including clinical, radiological, biochemical, and cytological features, have been investigated as predictors of malignancy in ITNs.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The impact of nodule size on malignancy risk in indeterminate thyroid nodules

Alqahtani,

Albalawi,

Alalawi

et al. 2024

Gland Surg

View full text Add to dashboard Cite

Background The association between malignancy risk and nodule size in indeterminate thyroid nodules (ITNs) remains controversial. Thus, we aimed to explore the impact of nodule size as a predictor of cancer in patients with ITNs. Methods This cross-sectional study assessed 113 patients who underwent surgical intervention for ITNs, comparing two groups based on nodule size (≥4 or <4 cm). The correlation between nodule size and malignancy risk was examined. Other variables of interest included demographics, thyroid-stimulating hormone (TSH) levels, type of surgery, and ultrasound features. Results Of the 113 patients, 88.5% were aged <55 years, 76.1% were women, and 65.5% had nodules <4 cm. Mean nodule size was 3.4±2.3 cm. There was no significant correlation between malignancy risk and nodule size (P=0.55). An association was observed between <4 cm nodules and elevated TSH levels (P=0.03) and between ≥4 cm nodules and the presence of hypervascularity (P=0.04). Nodules <4 cm were more likely to have extrathyroidal extension, lymphovascular invasion, and positive margins than those ≥4 cm; however, this was not significant. Conclusions Our findings showed no association between nodule size and malignancy risk, suggesting that size alone is not a predictor of cancer development. Further prospective studies are required to confirm these results.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The impact of nodule size on malignancy risk in indeterminate thyroid nodules

Alqahtani,

Albalawi,

Alalawi

et al. 2024

Gland Surg

View full text Add to dashboard Cite

show abstract

Effect of Pingxiao capsule on thyroid nodules and its influence on serum TGF-β1 and IGF-1 levels

Zhang

2024

BIO Web Conf.

View full text Add to dashboard Cite

aTo investigate the effect of Pingxiao capsule on the treatment of thyroid nodules and its effect on the levels of serum transforming growth factor-β1 (TGF-β1) and insulin-like growth factor 1 (IGF-1). Eighty-six patients with thyroid nodules admitted to the First Hospital Affiliated to Heilongjiang University of Traditional Chinese Medicine were selected and divided into 2 groups according to the random number table method. In the study, the control group received sodiumlevothyroxine treatment, while the observation group received a combination of Pingxiao capsule and sodiumlevothyroxine. A comparative analysis was conducted between the two groups, assessing Chinese medicine symptom scores, clinical effectiveness, thyroid nodule size, thyroid function indices, serum levels of TGF-β1 and IGF-1, as well as adverse reactions. RESULTS: Post-treatment, both groups exhibited decreased scores in patients with palpable neck nodules, laryngeal obstruction, depression, Shantaixi, and dizziness (P<0.05). Notably, the observation group demonstrated lower scores than the control group (P<0.05). The observation group exhibited a higher total effective rate compared to the control group (P<0.05). Reductions in thyroid nodule sizes and serum thyrotropin (TSH) levels were observed in both groups after treatment (P<0.05), with the observation group displaying lower values than the control group (P<0.05). Additionally, serum free tri-iodothyronine (FT3) and free tetra-iodothyronine (FT4) levels increased in both groups (P<0.05), with the observation group showing higher levels (P<0.05). Post-treatment, serum TGF-β1 levels increased in both groups (P<0.05), with the observation group exhibiting higher levels (P<0.05). Moreover, serum IGF-1 levels decreased in both groups (P<0.05), and the observation group displayed lower levels than the control group (P<0.05). Importantly, there was no statistically significant difference in the incidence rate of adverse reactions between the two groups (P>0.05). Pingxia capsule used in the treatment of patients with thyroid nodules can reduce clinical symptoms, improve the therapeutic effect, and at the same time can promote the recovery of thyroid function and regulate the serum TGF-β1, IGF-1 levels.

show abstract

A Scoping Review of Patient Health-Related Quality of Life Following Surgery or Molecular Testing for Individuals with Indeterminate Thyroid Nodules

Brouillette,

Chowdhury,

Payne

et al. 2024

Healthcare

View full text Add to dashboard Cite

Background: Molecular testing can reduce the need for diagnostic thyroidectomy in cytologically indeterminate thyroid nodules. However, the health-related quality of life in patients managed with molecular testing is not well studied. Objective: The objective of this scoping review was to identify and analyze the health-related quality of life outcomes in patients with indeterminate thyroid nodules who are expected to undergo or have undergone surgery or molecular testing. Methods: A comprehensive search was conducted on PubMed, Scopus, PsychINFO, and Embase to identify relevant studies. The search terms included “thyroid neoplasms” or “thyroid nodule” and “molecular testing” or “surgery” and “quality of life”. The included articles were analyzed for their main study objective, study design, participant characteristics, and main results. Results: Eight studies were included in this scoping review. Four evaluated the quality-adjusted life years for patients with indeterminate thyroid nodules. Three of these studies found that molecular testing slightly improved quality-adjusted life years compared to surgery, while one study found no difference. Two studies assessed surgical health-related quality of life outcomes and reported that patients with indeterminate thyroid nodules who were expected to undergo surgery favored surgical procedures, while those who underwent surgery experienced impaired health-related quality of life. Two studies evaluated molecular testing in patients with indeterminate thyroid nodules and found that the final molecular test result significantly impacted health-related quality of life outcomes. Patients with suspicious/positive molecular test results had worse symptoms of goiter, anxiety, and depression, while those with benign results had preserved health-related quality of life scores. Patients with benign results from molecular testing experience better health-related quality of life within the first year compared to those with benign surgical outcomes. Conclusions: This scoping review highlights the importance of considering health-related quality of life outcomes in the management of patients with indeterminate thyroid nodules. Benign molecular testing results yield better quality of life than benign surgical outcomes within the first year, suggesting molecular testing as a preferable option. Further research comparing the impact of surgery and molecular testing on health-related quality of life is needed to improve shared decision-making and patient outcomes.

show abstract

Current controversies in the management of patients with indeterminate thyroid nodules

Cited by 3 publications

References 55 publications

The impact of nodule size on malignancy risk in indeterminate thyroid nodules

The impact of nodule size on malignancy risk in indeterminate thyroid nodules

Effect of Pingxiao capsule on thyroid nodules and its influence on serum TGF-β1 and IGF-1 levels

A Scoping Review of Patient Health-Related Quality of Life Following Surgery or Molecular Testing for Individuals with Indeterminate Thyroid Nodules

Contact Info

Product

Resources

About