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- Title
Follow‐up of large thyroid nodules without surgery: Patient selection and long‐term outcomes.
- Authors
Cohen, Oded; Yarkoni, Tom Raz; Lahav, Yonatan; Schindel, Doron; Halperin, Doron; Yehuda, Moshe; Zornitzki, Taiba
- Abstract
Background: The management of large thyroid nodules remains controversial. Mandatory resection is recommended by some authors. Methods: All patients with thyroid nodules ≥3 cm between January 2009 and January 2013 were followed until August 2017. Follow‐up data were collected using an integrated hospital‐community system. Results: A total of 141 nodules were included. Of these, 37/141 (26%) nodules were initially referred to surgery, resulting in a 32% malignancy rate (12/37). The remaining 104/141 (74%) were referred to follow‐up. During the follow‐up period, 24 additional operations were done, resulting in a 4% malignancy rate (1/24). An indication of nonbenign cytology was significantly associated with malignancy compared with other indications. Median follow‐up was 53.5 months. No patient developed regional or distal diseases. The mean change in nodule size during the follow‐up period was a 7% reduction, with no significant trend of change over time. Conclusion: Careful patient selection based on clinical, sonographic, and cytologic features can reduce diagnostic surgery allowing for safe follow‐up of large thyroid nodules without surgery.
- Subjects
PATIENT selection; CYTODIAGNOSIS; THYROID gland tumors; SURGICAL diagnosis; THYROID gland physiology; THYROID gland surgery
- Publication
Head & Neck, 2019, Vol 41, Issue 6, p1696
- ISSN
1043-3074
- Publication type
Article
- DOI
10.1002/hed.25641