Unnecessary thyroid surgery rate for suspicious nodule in the absence of molecular testing
Background: Molecular tests for suspicious thyroid nodules decrease rates of unnecessary surgeries but are not widely used due to reimbursement issues. The aim of this study was to assess the rate of unnecessary surgery performed in real-life setting for Bethesda III, IV and V nodules in the absence...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Bioscientifica
2023-10-01
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| Series: | European Thyroid Journal |
| Subjects: | |
| Online Access: | https://etj.bioscientifica.com/view/journals/etj/12/6/ETJ-23-0114.xml |
| _version_ | 1797659313695621120 |
|---|---|
| author | Maria Mavromati Essia Saiji Marco Stefano Demarchi Vincent Lenoir Amanda Seipel Paulina Kuczma François R Jornayvaz Minerva Becker Eugenio Fernandez Claudio De Vito Frédéric Triponez Sophie Leboulleux |
| author_facet | Maria Mavromati Essia Saiji Marco Stefano Demarchi Vincent Lenoir Amanda Seipel Paulina Kuczma François R Jornayvaz Minerva Becker Eugenio Fernandez Claudio De Vito Frédéric Triponez Sophie Leboulleux |
| author_sort | Maria Mavromati |
| collection | DOAJ |
| description | Background: Molecular tests for suspicious thyroid nodules decrease rates of unnecessary surgeries but are not widely used due to reimbursement issues. The aim of this study was to assess the rate of unnecessary surgery performed in real-life setting for Bethesda III, IV and V nodules in the absence of molecular testing.
Method: This is a single-center retrospective study of consecutive patients undergoing fine needle aspiration cytology (FNAC) with rapid on-site evaluation between January 2017 and December 2021. Unnecessary surgery was defined as surgery performed because of Bethesda III, IV, or V results in the absence of local compressive symptoms with final benign pathology and as second surgery for completion thyroidectomy.
Results: In the 862 patients (640 females, mean age: 54.2 years), 1010 nodules (median size: 24.4 mm) underwent 1189 FNAC. Nodules were EU-TIRADS 2, 3, 4, and 5 in 3%, 34%, 42%, and 22% of cases, respectively. FNAC was Bethesda I, II, III, IV, V, and VI in 8%, 48%, 17%, 17%, 3%, and 6%, respectively. Surgery was performed in 36% of Bethesda III nodules (benign on pathology: 81%), in 74% of Bethesda IV nodules (benign on pathology: 76%) and in 97% of Bethesda V nodules (benign on pathology: 21%). Surgery was considered unnecessary in 56%, 68%, and 21% of patients with Bethesda III, IV, and V nodules, respectively.
Conclusion: In this real data cohort surgery was unnecessary in more than half of patients with Bethesda III and IV nodules and in 21% of patients with Be thesda V nodules. |
| first_indexed | 2024-03-11T18:13:12Z |
| format | Article |
| id | doaj.art-6d78b9957e4144c786fa1ae26fdbcc96 |
| institution | Directory Open Access Journal |
| issn | 2235-0802 |
| language | English |
| last_indexed | 2024-03-11T18:13:12Z |
| publishDate | 2023-10-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | European Thyroid Journal |
| spelling | doaj.art-6d78b9957e4144c786fa1ae26fdbcc962023-10-16T11:06:59ZengBioscientificaEuropean Thyroid Journal2235-08022023-10-0112618https://doi.org/10.1530/ETJ-23-0114Unnecessary thyroid surgery rate for suspicious nodule in the absence of molecular testingMaria Mavromati0Essia Saiji1Marco Stefano Demarchi2Vincent Lenoir3Amanda Seipel4Paulina Kuczma5François R Jornayvaz6Minerva Becker7Eugenio Fernandez8Claudio De Vito9Frédéric Triponez10Sophie Leboulleux11Department of Endocrinology, Diabetology, Nutrition and Therapeutic Education, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva University, Geneva, SwitzerlandDepartment of Pathology, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, SwitzerlandDepartment of Endocrine Surgery, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, SwitzerlandDepartment of Radiology, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, SwitzerlandDepartment of Pathology, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, SwitzerlandDepartment of Endocrine Surgery, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, SwitzerlandDepartment of Endocrinology, Diabetology, Nutrition and Therapeutic Education, Geneva University Hospitals, Rue Gabrielle Perret Gentil, GenevaDepartment of Radiology, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, SwitzerlandDepartment of Oncology, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, SwitzerlandDepartment of Pathology, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, SwitzerlandDepartment of Endocrine Surgery, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva, SwitzerlandDepartment of Endocrinology, Diabetology, Nutrition and Therapeutic Education, Geneva University Hospitals, Rue Gabrielle Perret Gentil, Geneva University, Geneva, SwitzerlandBackground: Molecular tests for suspicious thyroid nodules decrease rates of unnecessary surgeries but are not widely used due to reimbursement issues. The aim of this study was to assess the rate of unnecessary surgery performed in real-life setting for Bethesda III, IV and V nodules in the absence of molecular testing. Method: This is a single-center retrospective study of consecutive patients undergoing fine needle aspiration cytology (FNAC) with rapid on-site evaluation between January 2017 and December 2021. Unnecessary surgery was defined as surgery performed because of Bethesda III, IV, or V results in the absence of local compressive symptoms with final benign pathology and as second surgery for completion thyroidectomy. Results: In the 862 patients (640 females, mean age: 54.2 years), 1010 nodules (median size: 24.4 mm) underwent 1189 FNAC. Nodules were EU-TIRADS 2, 3, 4, and 5 in 3%, 34%, 42%, and 22% of cases, respectively. FNAC was Bethesda I, II, III, IV, V, and VI in 8%, 48%, 17%, 17%, 3%, and 6%, respectively. Surgery was performed in 36% of Bethesda III nodules (benign on pathology: 81%), in 74% of Bethesda IV nodules (benign on pathology: 76%) and in 97% of Bethesda V nodules (benign on pathology: 21%). Surgery was considered unnecessary in 56%, 68%, and 21% of patients with Bethesda III, IV, and V nodules, respectively. Conclusion: In this real data cohort surgery was unnecessary in more than half of patients with Bethesda III and IV nodules and in 21% of patients with Be thesda V nodules.https://etj.bioscientifica.com/view/journals/etj/12/6/ETJ-23-0114.xmlbethesda iiibethesda ivunnecessary thyroid surgeryrate of malignancy |
| spellingShingle | Maria Mavromati Essia Saiji Marco Stefano Demarchi Vincent Lenoir Amanda Seipel Paulina Kuczma François R Jornayvaz Minerva Becker Eugenio Fernandez Claudio De Vito Frédéric Triponez Sophie Leboulleux Unnecessary thyroid surgery rate for suspicious nodule in the absence of molecular testing European Thyroid Journal bethesda iii bethesda iv unnecessary thyroid surgery rate of malignancy |
| title | Unnecessary thyroid surgery rate for suspicious nodule in the absence of molecular testing |
| title_full | Unnecessary thyroid surgery rate for suspicious nodule in the absence of molecular testing |
| title_fullStr | Unnecessary thyroid surgery rate for suspicious nodule in the absence of molecular testing |
| title_full_unstemmed | Unnecessary thyroid surgery rate for suspicious nodule in the absence of molecular testing |
| title_short | Unnecessary thyroid surgery rate for suspicious nodule in the absence of molecular testing |
| title_sort | unnecessary thyroid surgery rate for suspicious nodule in the absence of molecular testing |
| topic | bethesda iii bethesda iv unnecessary thyroid surgery rate of malignancy |
| url | https://etj.bioscientifica.com/view/journals/etj/12/6/ETJ-23-0114.xml |
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