Fine-Needle Aspiration of Subcentimeter Thyroid Nodules in the Real-World Management
Chaiho Jeong,1 Hyunsam Kim,1 Jeongmin Lee,2 Jeonghoon Ha,1 Min-Hee Kim,2 Moo Il Kang,1 Dong-Jun Lim1 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; 2Divi...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2020-08-01
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| Series: | Cancer Management and Research |
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| Online Access: | https://www.dovepress.com/fine-needle-aspiration-of-subcentimeter-thyroid-nodules-in-the-real-wo-peer-reviewed-article-CMAR |
| _version_ | 1828451662740586496 |
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| author | Jeong C Kim H Lee J Ha J Kim MH Kang MI Lim DJ |
| author_facet | Jeong C Kim H Lee J Ha J Kim MH Kang MI Lim DJ |
| author_sort | Jeong C |
| collection | DOAJ |
| description | Chaiho Jeong,1 Hyunsam Kim,1 Jeongmin Lee,2 Jeonghoon Ha,1 Min-Hee Kim,2 Moo Il Kang,1 Dong-Jun Lim1 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; 2Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaCorrespondence: Dong-Jun LimDivision of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-Daero, Seocho-Gu, Seoul 06591, Republic of KoreaTel +82-2-2258-6009Fax +82-2-599-3589Email ldj6026@catholic.ac.krBackground: The Korea Thyroid Association published the revised guidelines for thyroid nodules in 2016. However, whether fine-needle aspiration is accurately performed based on indications and whether the results of this procedure are appropriately addressed according to clinical guidelines, particularly in subcentimeter nodules, are unclear.Methods: We retrospectively analyzed the fine-needle aspiration data of 331 thyroid nodules of patients who were referred to a tertiary hospital clinic for fine-needle aspiration. Each nodule was categorized according to ultrasonography findings based on the recommendations of the Korea Thyroid Association for fine-needle aspiration. Only nodules with a final pathological diagnosis of benign or malignant made using the Bethesda system were included.Results: Up to 32% of thyroid nodules that were not indicated for fine-needle aspiration were aspirated. Regarding subcentimeter nodules, only 28 of 123 (22.8%) aspirated nodules were indicated for fine-needle aspiration. Of the 49 malignant subcentimeter nodules, 33 (67.3%) underwent immediate surgery. Meanwhile, 14 (28.6%) nodules were lost to follow-up, and two (4.1%) were under active surveillance. Eighteen (36.7%) malignant subcentimeter nodules were not indicated for fine-needle aspiration but underwent surgical resection instead of active surveillance.Conclusion: Despite the recommendations in the revised guidelines, several thyroid nodules that do not meet the indications for FNA are aspirated in real-world practice. To reduce overtreatment, a widespread knowledge of the correct indications for fine-needle aspiration is important in clinical practice, particularly for subcentimeter nodules.Keywords: thyroid nodule, fine-needle aspiration, thyroid cancer, KTA guidelines |
| first_indexed | 2024-12-10T23:40:46Z |
| format | Article |
| id | doaj.art-0a99ddc05608405e8ee8afacf7076ce1 |
| institution | Directory Open Access Journal |
| issn | 1179-1322 |
| language | English |
| last_indexed | 2024-12-10T23:40:46Z |
| publishDate | 2020-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Cancer Management and Research |
| spelling | doaj.art-0a99ddc05608405e8ee8afacf7076ce12022-12-22T01:29:03ZengDove Medical PressCancer Management and Research1179-13222020-08-01Volume 127611761856459Fine-Needle Aspiration of Subcentimeter Thyroid Nodules in the Real-World ManagementJeong CKim HLee JHa JKim MHKang MILim DJChaiho Jeong,1 Hyunsam Kim,1 Jeongmin Lee,2 Jeonghoon Ha,1 Min-Hee Kim,2 Moo Il Kang,1 Dong-Jun Lim1 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; 2Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of KoreaCorrespondence: Dong-Jun LimDivision of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-Daero, Seocho-Gu, Seoul 06591, Republic of KoreaTel +82-2-2258-6009Fax +82-2-599-3589Email ldj6026@catholic.ac.krBackground: The Korea Thyroid Association published the revised guidelines for thyroid nodules in 2016. However, whether fine-needle aspiration is accurately performed based on indications and whether the results of this procedure are appropriately addressed according to clinical guidelines, particularly in subcentimeter nodules, are unclear.Methods: We retrospectively analyzed the fine-needle aspiration data of 331 thyroid nodules of patients who were referred to a tertiary hospital clinic for fine-needle aspiration. Each nodule was categorized according to ultrasonography findings based on the recommendations of the Korea Thyroid Association for fine-needle aspiration. Only nodules with a final pathological diagnosis of benign or malignant made using the Bethesda system were included.Results: Up to 32% of thyroid nodules that were not indicated for fine-needle aspiration were aspirated. Regarding subcentimeter nodules, only 28 of 123 (22.8%) aspirated nodules were indicated for fine-needle aspiration. Of the 49 malignant subcentimeter nodules, 33 (67.3%) underwent immediate surgery. Meanwhile, 14 (28.6%) nodules were lost to follow-up, and two (4.1%) were under active surveillance. Eighteen (36.7%) malignant subcentimeter nodules were not indicated for fine-needle aspiration but underwent surgical resection instead of active surveillance.Conclusion: Despite the recommendations in the revised guidelines, several thyroid nodules that do not meet the indications for FNA are aspirated in real-world practice. To reduce overtreatment, a widespread knowledge of the correct indications for fine-needle aspiration is important in clinical practice, particularly for subcentimeter nodules.Keywords: thyroid nodule, fine-needle aspiration, thyroid cancer, KTA guidelineshttps://www.dovepress.com/fine-needle-aspiration-of-subcentimeter-thyroid-nodules-in-the-real-wo-peer-reviewed-article-CMARthyroid nodulefine-needle aspirationthyroid cancerkta guidelines |
| spellingShingle | Jeong C Kim H Lee J Ha J Kim MH Kang MI Lim DJ Fine-Needle Aspiration of Subcentimeter Thyroid Nodules in the Real-World Management Cancer Management and Research thyroid nodule fine-needle aspiration thyroid cancer kta guidelines |
| title | Fine-Needle Aspiration of Subcentimeter Thyroid Nodules in the Real-World Management |
| title_full | Fine-Needle Aspiration of Subcentimeter Thyroid Nodules in the Real-World Management |
| title_fullStr | Fine-Needle Aspiration of Subcentimeter Thyroid Nodules in the Real-World Management |
| title_full_unstemmed | Fine-Needle Aspiration of Subcentimeter Thyroid Nodules in the Real-World Management |
| title_short | Fine-Needle Aspiration of Subcentimeter Thyroid Nodules in the Real-World Management |
| title_sort | fine needle aspiration of subcentimeter thyroid nodules in the real world management |
| topic | thyroid nodule fine-needle aspiration thyroid cancer kta guidelines |
| url | https://www.dovepress.com/fine-needle-aspiration-of-subcentimeter-thyroid-nodules-in-the-real-wo-peer-reviewed-article-CMAR |
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