BACKGROUND: The impact of oncogene panel results on the surgical management of indeterminate thyroid nodules (ITNs) is currently unknown. METHODS: Surgical management of 649 patients consecutively evaluated from October 2008 to April 2016 with a single nodule biopsied and indeterminate cytology (193 evaluated with and 456 without oncogene panels) was assessed and compared. Histological features of 629 consecutively resected ITNs (164 evaluated with and 465 without oncogene panels) were also characterized and compared. RESULTS: Oncogene panel evaluation was associated with higher rates of total thyroidectomy (45% vs 28%; P = .006), and central lymph node dissection (19% vs 12%; P = .03) without increasing the yield of malignancy or decreasing the rate of completion thyroidectomy. Most malignancies (64%), including 83% of those with driver mutation identified, were low-risk cancers for which a lobectomy could have been sufficient initial treatment. CONCLUSION: Current oncogene panel results seem insufficient to guide the surgical extent of solitary ITNs.
BACKGROUND: The impact of oncogene panel results on the surgical management of indeterminate thyroid nodules (ITNs) is currently unknown. METHODS: Surgical management of 649 patients consecutively evaluated from October 2008 to April 2016 with a single nodule biopsied and indeterminate cytology (193 evaluated with and 456 without oncogene panels) was assessed and compared. Histological features of 629 consecutively resected ITNs (164 evaluated with and 465 without oncogene panels) were also characterized and compared. RESULTS: Oncogene panel evaluation was associated with higher rates of total thyroidectomy (45% vs 28%; P = .006), and central lymph node dissection (19% vs 12%; P = .03) without increasing the yield of malignancy or decreasing the rate of completion thyroidectomy. Most malignancies (64%), including 83% of those with driver mutation identified, were low-risk cancers for which a lobectomy could have been sufficient initial treatment. CONCLUSION: Current oncogene panel results seem insufficient to guide the surgical extent of solitary ITNs.
Authors: Pablo Valderrabano; Melissa J McGettigan; Cesar A Lam; Laila Khazai; Zachary J Thompson; Christine H Chung; Barbara A Centeno; Bryan McIver Journal: Thyroid Date: 2018-07-17 Impact factor: 6.568
Authors: Pablo Valderrabano; Laila Khazai; Zachary J Thompson; Kristen J Otto; Julie E Hallanger-Johnson; Christine H Chung; Barbara A Centeno; Bryan McIver Journal: JAMA Otolaryngol Head Neck Surg Date: 2018-09-01 Impact factor: 6.223
Authors: Trevor E Angell; Lori J Wirth; Maria E Cabanillas; Maisie L Shindo; Edmund S Cibas; Joshua E Babiarz; Yangyang Hao; Su Yeon Kim; P Sean Walsh; Jing Huang; Richard T Kloos; Giulia C Kennedy; Steven G Waguespack Journal: Front Endocrinol (Lausanne) Date: 2019-09-11 Impact factor: 5.555
Authors: Whitney S Goldner; Trevor E Angell; Sallie Lou McAdoo; Joshua Babiarz; Peter M Sadow; Fadi A Nabhan; Christian Nasr; Richard T Kloos Journal: Thyroid Date: 2019-09-27 Impact factor: 6.568