M Jinih1, F Faisal2, K Abdalla1, M Majeed3, A A Achakzai3, C Heffron4, J McCarthy4, H P Redmond1,3. 1. Department of Academic Surgery, Cork University Hospital, Wilton, Cork, Ireland. 2. School of Medicine, University College Cork, Cork, Ireland. 3. Department of ENDOCRINE SURGERY, Cork University Hospital, Wilton, Cork, Ireland. 4. Department of Pathology, Cork University Hospital, Wilton, Cork, Ireland.
Abstract
INTRODUCTION: The diagnostic performance of ultrasound-fine needle aspiration to identify thyroid nodules harbouring malignancy remains variable. The aim of this study was to determine thyroid nodule size and cytological classification as predictors of malignancy risk. MATERIALS AND METHODS: We conducted a retrospective cohort analysis at an academic hospital involving 499 consecutive patients who underwent thyroid surgery between 2004 and 2015. RESULTS: A total of 503 thyroid nodules (499 patients, 84% female; mean age 50.8 years, standard deviation, SD, 15.4 years) were analysed. Of these, 19.5% were malignant. The mean (± SD) nodule size was 3.28 ± 1.63 cm and 3.27 ± 1.54 cm for benign and malignant nodules, respectively. The odds of malignancy for thyroid nodules less than 3.0 cm was similar to those for nodules of 3.0 cm or greater (0.26 compared with 0.29; p=0.77). Overall, the sensitivity and specificity of fine-needle aspiration in this cohort were 71.4% and 100%, respectively. The overall false negative rate was 5.4%. When the cut-off of 3.0 cm was used, the false negative rate in thyroid nodules less than 3.0 cm was 0% compared with 7.0% in nodules of 3.0 cm or greater. Thus, class (p<0.01) but not nodule size (p=0.49), was associated with higher malignancy risk. CONCLUSIONS: Our results suggest that thyroid nodule size did not accurately predict the risk of thyroid malignancy irrespective of fine-needle aspiration cytology. Routine diagnostic thyroid lobectomy solely owing to thyroid nodule size of 3.0 cm or greater is currently not justified.
INTRODUCTION: The diagnostic performance of ultrasound-fine needle aspiration to identify thyroid nodules harbouring malignancy remains variable. The aim of this study was to determine thyroid nodule size and cytological classification as predictors of malignancy risk. MATERIALS AND METHODS: We conducted a retrospective cohort analysis at an academic hospital involving 499 consecutive patients who underwent thyroid surgery between 2004 and 2015. RESULTS: A total of 503 thyroid nodules (499 patients, 84% female; mean age 50.8 years, standard deviation, SD, 15.4 years) were analysed. Of these, 19.5% were malignant. The mean (± SD) nodule size was 3.28 ± 1.63 cm and 3.27 ± 1.54 cm for benign and malignant nodules, respectively. The odds of malignancy for thyroid nodules less than 3.0 cm was similar to those for nodules of 3.0 cm or greater (0.26 compared with 0.29; p=0.77). Overall, the sensitivity and specificity of fine-needle aspiration in this cohort were 71.4% and 100%, respectively. The overall false negative rate was 5.4%. When the cut-off of 3.0 cm was used, the false negative rate in thyroid nodules less than 3.0 cm was 0% compared with 7.0% in nodules of 3.0 cm or greater. Thus, class (p<0.01) but not nodule size (p=0.49), was associated with higher malignancy risk. CONCLUSIONS: Our results suggest that thyroid nodule size did not accurately predict the risk of thyroid malignancy irrespective of fine-needle aspiration cytology. Routine diagnostic thyroid lobectomy solely owing to thyroid nodule size of 3.0 cm or greater is currently not justified.
Authors: John R Porterfield; Clive S Grant; Diana S Dean; Geoffrey B Thompson; David R Farley; Melanie L Richards; Carl C Reading; J William Charboneau; Brenda K Vollrath; Thomas J Sebo Journal: Surgery Date: 2008-12 Impact factor: 3.982
Authors: Laura I Wharry; Kelly L McCoy; Michael T Stang; Michaele J Armstrong; Shane O LeBeau; Mitch E Tublin; Biatta Sholosh; Ari Silbermann; N Paul Ohori; Yuri E Nikiforov; Steven P Hodak; Sally E Carty; Linwah Yip Journal: World J Surg Date: 2014-03 Impact factor: 3.352
Authors: Wesley H Giles; Reid A Maclellan; Atul A Gawande; Daniel T Ruan; Erik K Alexander; Francis D Moore; Nancy L Cho Journal: Ann Surg Oncol Date: 2014-07-30 Impact factor: 5.344