The Biopsy-Proven Benign Thyroid Nodule: Is Long-Term Follow-Up Necessary?

Lee, Sukhyung; Skelton, T. Spencer; Zheng, Feibi; Schwartz, Katherine A.; Perrier, Nancy D.; Lee, Jeffrey E.; Bassett, Roland L.; Ahmed, Salmaan; Krishnamurthy, Savitri; Busaidy, Naifa L.; Grubbs, Elizabeth G.

doi:10.1016/j.jamcollsurg.2013.03.014

Cited by 37 publications

(27 citation statements)

References 20 publications

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“…Noteworthy, no distant metastases were observed and all patients were alive at an average of 11 years following the FNA. According to Lee et al [54] a long-term follow-up of thyroid nodules, initially benign by FNA, does not improve the cancer detection rate. A group of 738 patients with FNA-confirmed benign thyroid nodules were observed at the MD Anderson Center.…”

Section: What Is the Evidence That Molecular Fna Diagnostics With A Gmentioning

confidence: 99%

“…The number of ultrasonographies and repeated FNAs was significantly higher in the long-term group; however, surgical resection of the nodule as well as malignancy rate at final histopathological examination was similar between the 2 groups. Thus, stopping further follow-up after 3 years may be considered [54]. However, a longer follow-up of 8.1 years was proposed by Liel et al [55].…”

Section: What Is the Evidence That Molecular Fna Diagnostics With A Gmentioning

confidence: 99%

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European Thyroid Association Guidelines regarding Thyroid Nodule Molecular Fine-Needle Aspiration Cytology Diagnostics

Paschke¹,

Cantara²,

Crescenzi³

et al. 2017

Eur Thyroid J

139

136

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Molecular fine-needle aspiration (FNA) cytology diagnostics has the potential to address the inherent limitation of FNA cytology which is an indeterminate (atypia of undetermined significance/follicular lesion of undetermined significance follicular neoplasm) cytology. Because of the emerging role of molecular FNA cytology diagnostics, the European Thyroid Association convened a panel of international experts to review methodological aspects, indications, results, and limitations of molecular FNA cytology diagnostics. The panel reviewed the evidence for the diagnostic value of mutation panel assessment (including at least BRAF, NRAS, HRAS, KRAS, PAX8/PPARG, RET/PTC) of targeted next generation sequencing and of a microarray gene expression classifier (GEC) test in the diagnostic assessment of an indeterminate cytology thyroid nodule. Moreover, possible surgical consequences of molecular FNA diagnostic results of thyroid nodules and the evidence that analysis of a molecular FNA diagnostic panel of somatic mutations or a microarray GEC test can alter the follow-up were reviewed. Molecular tests may help clinicians to drive patient care and the surgical decision if the analysis is performed in specialized laboratories. These molecular tests require standardization of performance characteristics and appropriate calibration as well as analytic validation before clinical interpretation.

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Section: What Is the Evidence That Molecular Fna Diagnostics With A Gmentioning

confidence: 99%

Section: What Is the Evidence That Molecular Fna Diagnostics With A Gmentioning

confidence: 99%

European Thyroid Association Guidelines regarding Thyroid Nodule Molecular Fine-Needle Aspiration Cytology Diagnostics

Paschke¹,

Cantara²,

Crescenzi³

et al. 2017

Eur Thyroid J

139

136

View full text Add to dashboard Cite

show abstract

“…Recent studies have found that even thyroid solid nodules which were diagnosed by fine-needle aspiration as benign lesions still had 6% possibility of being malignant lesions diagnosed by surgical pathology 7. Therefore, active treatments should be conducted for suspected malignant thyroid nodules diagnosed by clinical and imaging examinations 8. Treatment are also needed for some benign nodules due to compression symptoms caused by large volumes, local uplift affecting appearance, or possibility of malignancy 9.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the safety and efficacy of radiofrequency ablation for treating benign thyroid nodules

Tang¹,

Cui²,

Chi³

et al. 2017

J. Cancer

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Background: Radiofrequency ablation (RFA) is a relatively new procedure for treating benign thyroid nodules. The purpose of this study was to evaluate the safety and efficacy of RFA for treating benign thyroid nodules so as to serve as a reference for future clinical practice.Methods: This study retrospectively analyzed the clinical data of patients receiving percutaneous RFA for treating thyroid nodules from November 2014 to July 2015 in our medical center. One hundred and eight patients with a total of 380 nodules received ultrasound-guided RFA for treating thyroid nodules. Comparisons of the volume change of thyroid nodules before and after RFA treatment, post-treatment complication, and change of thyroid function, were carried out afterwards.Results: Before treatments, all patients received fine needle aspiration biopsy (FNA) which supported the diagnosis of benign tumor. There were 13 males and 95 females included in the study. Twenty-six cases (24.07%) had single nodule, and 82 cases (75.93%) had multiple nodules. Before treatments, the thyroid functions (FT3, FT4, and TSH) were normal originally or adjusted to normal range by endocrinology treatment. The preoperative nodules had minimum volume of 0.01mL, maximum volume of 70.89 mL, and mean volume of 1.02 ± 4.24mL. The volume of nodules one month and three months after RFA were 0.29 ± 0.72mL and 0.15 ± 0.87mL, respectively. In addition, volume reduction ratio (VRR) of nodules one month and three months after RFA were 64.12% and 85.54%, respectively. Both volume of nodules and VRR had statistically significant differences for pre-operative and post-operative comparison (P<0.05). Thyroid functions were in normal range after treatments, and there was no serious complications.Conclusions: Ultrasound-guided RFA treating benign thyroid nodules had the advantages of definite efficacy, safety, strong in control ability, no incision, less damage to surrounding normal tissues and no effect on thyroid function. It can be used as one of the main treatment methods for treating benign thyroid nodules.

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“…Interestingly, the most common indication for thyroidectomy during follow-up in many series is the development of compressive symptoms, which is an event unrelated to diagnostic uncertainty of the USFNA [8, 13, 14]. This suggests that routine clinical follow-up without repeat US or USFNA might be enough to identify patients in which further treatment is required.…”

Section: Discussionmentioning

confidence: 99%

Prognosis of patients with benign thyroid nodules: a population-based study

et al. 2016

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Most thyroid nodules are benign. The ideal follow-up of these patients should reflect their prognosis, which has been scarcely investigated. We aimed to evaluate the prognosis of patients with initial benign thyroid cytology. A population-based study, using the Rochester Epidemiology Project, identifying patients with benign thyroid cytology diagnosed between 2003 and 2006 and completely followed to 2014 using linked medical records. We identified 363 thyroid nodules with benign cytology in 327 patients after fine-needle aspiration biopsy. Patients were on average 53 years old (standard deviation 17), and 80 % were women. The median nodule size was 1.6 cm (interquartile range 1.2–2.4); 26 % had at least one suspicious ultrasound feature. During a median follow-up of 8 years, 54 patients (17 %) with 57 benign nodules underwent thyroidectomy, mostly due to compressive symptoms (44 %). Thyroidectomy was more likely in younger patients [hazard ratio (HR) 0.97, 95 % CI 0.96–0.99] and patients with larger nodules (HR 1.3, 95 % CI 1.16–1.48). Two patients were found to have follicular thyroid cancer in the index nodule (0.6 %) and 6 patients had papillary thyroid cancer detected in other nodules (1.8 %). No patient died from thyroid cancer. Patients with benign thyroid nodules are unlikely to suffer morbidity or mortality due to thyroid cancer. Follow-up strategies for these patients should consider this excellent prognosis and avoid causing unnecessary fear in patients and adding unneeded expense and burden to the healthcare system.

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The Biopsy-Proven Benign Thyroid Nodule: Is Long-Term Follow-Up Necessary?

Cited by 37 publications

References 20 publications

European Thyroid Association Guidelines regarding Thyroid Nodule Molecular Fine-Needle Aspiration Cytology Diagnostics

European Thyroid Association Guidelines regarding Thyroid Nodule Molecular Fine-Needle Aspiration Cytology Diagnostics

Evaluation of the safety and efficacy of radiofrequency ablation for treating benign thyroid nodules

Prognosis of patients with benign thyroid nodules: a population-based study

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