Risk stratification and long-term outcome of benign thyroid nodules - a 11-year cohort study.

IF 3.7 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Sapir Pinhas, Jonathan Cohen, Raviv Allon, Nadav Ben-David, Noam Koch, David Kiderman, Elchanan Zloczower, Taiba Zornitzki, Moshe Yehuda, Yonatan Lahav, Oded Cohen
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引用次数: 0

Abstract

Objectives: The recommended follow-up interval and length, as well as the indication for repat fine needle aspiration in benign nodules remains unclear up to date. The purpose of the study was to evaluate the long-term follow-up and management outcomes of benign thyroid nodules.

Methods: A retrospective study included 1,224 nodules from 1,071 patients with initial benign thyroid nodules, between 2010 and 2014. Phone calls were made to obtain updated information from patients when information was missing. The main outcome of the study was a change in the nodule's ROM - defined either as a malignant pathology (when obtained) or by cytology (repeated BSRTC III, IV, V, or VI). Secondary outcomes included the yield of repeated FNA. Data included demographics, sonographic data, follow-up adherence, repeat FNA results, surgery types, and pathologic results.

Results: The average follow-up period was 9.48 ± 1.72 years. 0.65% (7/1071) of patients remained without follow-up. The ROM was 3.43% (42/1224). Benign nodules >2 cm had a higher ROM compared to smaller nodules (5.3% vs. 1.3% respectively, p-value<0.001). Repeat FNA and a change in nodule size did not significantly change ROM. Among the 41 malignant nodules with documented size, 33 (80.49%) were nodules larger than 2 cm. A total of 35 cases (85.37%) were diagnosed within the first 3 years of follow-up.

Conclusion: ROM for benign nodules remains considerably low, especially for nodule smaller than 2 cm. Long-term follow-up and repeated FNA and follow-up for BTSC II thyroid nodules without suspicious features should be reconsidered.

良性甲状腺结节的风险分层和长期预后——一项为期11年的队列研究
目的:良性结节重复细针抽吸的推荐随访时间和长度以及适应症目前尚不清楚。本研究的目的是评估良性甲状腺结节的长期随访和治疗结果。方法:2010年至2014年间,对1071例初始良性甲状腺结节患者的1224个结节进行回顾性研究。当信息缺失时,他们会打电话从患者那里获取最新信息。该研究的主要结果是结节ROM的改变,定义为恶性病理(当获得时)或细胞学(重复BSRTC III, IV, V或VI)。次要结局包括重复FNA的产率。数据包括人口统计学、超声数据、随访依从性、重复FNA结果、手术类型和病理结果。结果:平均随访时间为9.48±1.72年。0.65%(7/1071)的患者没有随访。ROM为3.43%(42/1224)。小于2 cm的良性结节的ROM高于小于2 cm的结节(分别为5.3%和1.3%)。结论:良性结节的ROM仍然相当低,尤其是小于2 cm的结节。对于无可疑特征的BTSC型甲状腺结节,应重新考虑长期随访和反复FNA随访。
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来源期刊
Endocrine Practice
Endocrine Practice ENDOCRINOLOGY & METABOLISM-
CiteScore
7.60
自引率
2.40%
发文量
546
审稿时长
41 days
期刊介绍: Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.
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