February of 2011 and December of 2018. The authors included in the study only the patients with a ‘benign’ result on molecular testing.
The authors examined data from 270 patients (including results of 289 nodules). During the study, 37 patients (13.7% of the 270) underwent thyroid surgery. These 37 patients had 38 nodules that were studied. For the 37 patients who underwent surgery, the range of time from biopsy to surgery was 0.4 to 45.7 months. Of the 37 patients who had surgery, 13.5% (5/37) of patients were found to have thyroid cancer.
In a statistical analysis adjusting for multiple possible features, the risk factors that were significantly related to ultimately having surgery included: presence of another nodule that had a ‘suspicious’ for cancer result on the molecular test, having compressive symptoms (in the neck), nodule size 3cm or larger and age younger than 40 years.
WHAT ARE THE IMPLICATIONS OF THIS STUDY?
The main conclusion is that risk factors for thyroid surgery in patients who have an indeterminate thyroid biopsy with a ‘benign’ result on a molecular test include: presence of another nodule with a ‘suspicious’ molecular test result, compressive symptoms, larger nodule size, and younger age. These findings suggest that in spite of a ‘benign’ molecular test result, other factors may be important to patients and physicians in deciding whether to proceed with surgery for an indeterminate thyroid nodule.
— Anna Sawka, MD, PhD, FRCPC