Evidence map›Paper›PMID 27623969›Full record

ArticleEndocrine2017

Proposal for a novel management of indeterminate thyroid nodules on the basis of cytopathological subclasses.

Martina Rossi, Sabrina Lupo, Roberta Rossi, Paola Franceschetti, Giorgio Trasforini, Stefania Bruni, Federico Tagliati, Mattia Buratto, Giovanni Lanza, Luca Damiani and 2 more

Abstract read
PubMed Publisher
In one paragraph

Article in Endocrine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Molecular Variants and Their Risks for Malignancy in Cytologically Indeterminate Thyroid Nodules.Thyroid : official journal of the American Thyroid Association · 2019
    Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Review
  6. Cancer biology & medicine · 2019
    Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Martina RossiSection of Endocrinology & Internal Medicine, Department of Medical Sciences, University of Ferrara, Via Ariosto 35, Ferrara, 44121, Italy.
Sabrina LupoSection of Endocrinology & Internal Medicine, Department of Medical Sciences, University of Ferrara, Via Ariosto 35, Ferrara, 44121, Italy.
Roberta RossiEndocrinology Unit, Azienda Ospedaliero-Universitaria di Ferrara, Via Aldo Moro 8, Ferrara, 44124, Italy.
Paola FranceschettiEndocrinology Unit, Azienda Ospedaliero-Universitaria di Ferrara, Via Aldo Moro 8, Ferrara, 44124, Italy.
Giorgio TrasforiniEndocrinology Unit, Azienda Ospedaliero-Universitaria di Ferrara, Via Aldo Moro 8, Ferrara, 44124, Italy.
Stefania BruniEndocrinology Unit, Azienda Ospedaliero-Universitaria di Ferrara, Via Aldo Moro 8, Ferrara, 44124, Italy.
Federico TagliatiSection of Endocrinology & Internal Medicine, Department of Medical Sciences, University of Ferrara, Via Ariosto 35, Ferrara, 44121, Italy.
Mattia BurattoSection of Endocrinology & Internal Medicine, Department of Medical Sciences, University of Ferrara, Via Ariosto 35, Ferrara, 44121, Italy.
Giovanni LanzaSection of Pathology and Biomolecular Diagnostics, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Via Ariosto 35, Ferrara, 44121, Italy.
Luca DamianiSection of Endocrinology & Internal Medicine, Department of Medical Sciences, University of Ferrara, Via Ariosto 35, Ferrara, 44121, Italy.
Ettore Degli UbertiSection of Endocrinology & Internal Medicine, Department of Medical Sciences, University of Ferrara, Via Ariosto 35, Ferrara, 44121, Italy.
Maria Chiara ZatelliSection of Endocrinology & Internal Medicine, Department of Medical Sciences, University of Ferrara, Via Ariosto 35, Ferrara, 44121, Italy. ztlmch@unife.it.ORCID http://orcid.org/0000-0001-8408-7796

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Indeterminate thyroid nodules include heterogeneous lesions that could benefit from a differential management. Our aim is to better define the management of the Bethesda System for Reporting Thyroid Cytopathology class III and IV nodules, by identifying cytological subcategories among Bethesda System for Reporting Thyroid Cytopathology class III associated with different clinical risk, by means of ultrasound, repeated FNAB, and BRAFV600E molecular analysis. We also evaluated the outcome of nodules not operated, over a 5-year follow-up. Out of 460 nodules (269 Bethesda System for Reporting Thyroid Cytopathology class III and 191 Bethesda System for Reporting Thyroid Cytopathology class IV), 344 were operated on surgical group and 116 followed-up conservatively (follow-up group). Bethesda System for Reporting Thyroid Cytopathology class III was divided into four subcategories on the basis of cytomorphological features (III-1, III-2, III-3, III-4). Clinical risk was defined on the basis of histological, cytological, and ultrasound data. Malignancy was higher in Bethesda System for Reporting Thyroid Cytopathology class III vs. Bethesda System for Reporting Thyroid Cytopathology class IV (34.4 vs. 26.2 %; p < 0.01). Papillary thyroid carcinoma was the most frequent cancer in each Bethesda System for Reporting Thyroid Cytopathology class (35 %). BRAFV600E diagnostic accuracy was 87 %. Repeated FNAB reclassified as benign nearly 40 % of nodules, selecting patients where surgery could be spared. Significant nodule growth occurred in 13.7 % of nodules, belonging mostly to Bethesda System for Reporting Thyroid Cytopathology class III-2 and Bethesda System for Reporting Thyroid Cytopathology class IV. Overall clinical risk was higher in Bethesda System for Reporting Thyroid Cytopathology III-1, III-4, and IV classes. We propose a differential management of Bethesda System for Reporting Thyroid Cytopathology III and IV classes and related subcategories: surgery may be indicated in Bethesda System for Reporting Thyroid Cytopathology class III-1, III-4, and IV; a conservative follow-up avoiding repeated FNAB may be appropriated in class III-3, while repeated FNAB may be useful in class III-2.

Indexed as

AdultBiopsy, Fine-NeedleCarcinoma, PapillaryDisease ManagementFemaleFollow-Up StudiesHumansMaleMiddle AgedThyroid GlandThyroid NeoplasmsThyroid NoduleUltrasonographyCytological sub-categoriesIndeterminate thyroid noduleThyroid nodule clinical riskThyroid nodule management

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.