Patient-specific factors, patient preference, and nodule size as implications in the initial surgery of high risk indeterminate thyroid nodules.

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Pub Date : 2025-05-28 DOI:10.1007/s12020-025-04289-6

Lorenzo Scappaticcio, Nicole Di Martino, Pamela Ferrazzano, Stefano Lucà, Eduardo Clery, Miriam Longo, Vanda Amoresano Paglionico, Giovanni Cozzolino, Maria Ida Maiorino, Giovanni Docimo, Pierpaolo Trimboli, Renato Franco, Katherine Esposito, Giuseppe Bellastella

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引用次数: 0

Abstract

Purpose: To evaluate the frequency of total thyroidectomy (TT) for thyroid nodules cytologically classified as high-risk indeterminate (TIR3B) and to explore the impact of patient specific factors (PSFs) (some clinical variables) associated with TT for follicular thyroid carcinoma (FTC). Moreover, we aim to investigate the nodule size as a factor influencing the risk of malignancy (ROM) and the risk of aggressiveness of FTC.

Methods: We retrieved consecutive FTC cases, and an equal number of follicular adenoma (FA) from adult patients with TIR3B thyroid nodules, which were operated in our Academic referral center between March 1, 2018, and December 31, 2024.

Results: We reviewed 112 TIR3B thyroid nodules, histologically subdivided into 56 FTC cases and 56 FA cases. TT was performed in 83% of cases. PSFs were present in 47.4% of patients undergoing hemithyroidectomy (HT) and in 61.3% of patients undergoing TT. No statistical significance was found for PSFs as predictors of TT. For the 30 mm ≤ dmax <40 mm size category we found an odds ratio (OR) of 2.0 [1.101; 3.551] (p-value 0.022) for risk of FTC. We found the existence of a positive relationship between dimensions of FTC and its aggressiveness.

Conclusion: TT was largely performed as initial surgery for TIR3B thyroid nodules. PSFs and patient preferences should be explored when planning the initial surgical management of a nodule with TIR3B cytology. Large nodule size (30 ≤ dmax < 40) can be integrated into decision making for patients with a cytology of TIR3B, since it increases the risk of FTC. Larger FTC seems to be more aggressive.

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患者特异性因素、患者偏好和结节大小对高危不确定甲状腺结节初始手术的影响。

目的：评价细胞学分类为高危不确定（TIR3B）甲状腺结节的全甲状腺切除术（TT）频率，并探讨与滤泡性甲状腺癌（FTC） TT相关的患者特异性因素（PSFs）（一些临床变量）的影响。此外，我们的目的是研究结节大小作为影响恶性肿瘤（ROM）风险和FTC侵袭性风险的因素。方法：我们检索了2018年3月1日至2024年12月31日在我们的学术转诊中心手术的成人TIR3B甲状腺结节患者中连续的FTC病例和等量的滤泡腺瘤（FA）。结果：112例甲状腺TIR3B结节，病理上分为FTC 56例和FA 56例。83%的病例接受了TT治疗。47.4%的甲状甲状腺切除术（HT）患者和61.3%的TT患者存在PSFs。psf作为TT的预测因子无统计学意义。结论：TT主要作为TIR3B甲状腺结节的初始手术。当计划对带有TIR3B细胞学的结节进行初始手术治疗时，应探讨psf和患者的偏好。大结节尺寸（30≤dmax）

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来源期刊

Endocrine ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

5.40%

发文量

295

审稿时长

1.5 months

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.