A follow‐up study on thyroid aspirates reported as atypia of undetermined significance/follicular lesion of undetermined significance and follicular neoplasm/suspicious for follicular neoplasm: A multicenter study from the Arabian Gulf region

Al‐Abbadi, Mousa A.; Shareef, Sameera Q.; Yousef, Mohammad M.; Almasri, Nidal M.; Mustafa, Huda; Aljawad, Hameed; Ali, Jassim A.; Groves, Alan; Alsaihati, Yasmen

doi:10.1002/dc.23805

Cited by 8 publications

(8 citation statements)

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“…[7] Of note, several publications from the gulf region have lately focused on the group of indeterminate thyroid nodules (Atypia of unknown significance [AUS] and follicular neoplasm of unknown significance) with rates of cancer varying between 20% and 45%. [8] This contrasts with the higher figures observed in this study (38.1% and 69.1% for AUS and follicular neoplasm, respectively). This could be partly due to referral bias, lack of histology review to discern the group of NIFTP, expertise variability in cytology, and/or statistical bias.…”

Section: Commentarycontrasting

confidence: 86%

Thyroid nodules in the gulf: Renewed interest and ongoing debate

Khalil

Altrabulsi

Dina

2021

Journal of Diabetes and Endocrine Practice

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Section: Commentarycontrasting

confidence: 86%

Thyroid nodules in the gulf: Renewed interest and ongoing debate

Khalil

Altrabulsi

Dina

2021

Journal of Diabetes and Endocrine Practice

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“…Many centers report malignancy rates above the ~5-15% ROM stated by the 2009 Bethesda System (Table 4) [11,13,14,16,[19][20][21][22][23][26][27][28][29][30][31][32][33]. The 2017 Bethesda System states a Fig.…”

Section: Discussionmentioning

confidence: 99%

Rate of malignancy for thyroid nodules with AUS/FLUS cytopathology in a tertiary care center – a retrospective cohort study

Hathi

Rahmeh

Munro

et al. 2021

J of Otolaryngol - Head & Neck Surg

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Background Thyroid nodules are stratified through fine-needle aspiration (FNA) and are often categorized using The Bethesda System for Reporting Thyroid Cytopathology, which estimates the risk of malignancy for six cytopathological categories. The atypia of undetermined significance (AUS) and follicular lesion of undetermined significance (FLUS) categories have varying malignancy rates reported in the literature which can range from 6 to 72.9%. Due to this heterogeneity, we assessed the malignancy rate and effectiveness of repeat FNA (rFNA) for AUS/FLUS thyroid cytopathology at our institution. Methods Electronic health records of patients with AUS/FLUS thyroid cytopathology on FNA at our center since the implementation of the Bethesda System on May 1, 2014–December 31, 2019 were retrospectively reviewed. Patient demographics, treatment pathway, and pathology results were collected. The treatment pathway of the nodules, the rFNA results, and the malignant histopathology results were reported. Malignancy rates were calculated as an upper and lower limit estimate. Results This study described 182 AUS/FLUS thyroid nodules from 177 patients. In total, 24 thyroid nodules were deemed malignant upon histopathology, yielding a final malignancy rate of 13.2–25.3%. All of the malignancies were variants of papillary thyroid carcinoma. The malignancy rate of the nodules which underwent resection without rFNA (21.5%) was lower than the malignancy rate of the nodules which underwent resection after rFNA (43.8%). 45.5% of the rFNA results were re-classified into more definitive categories. Conclusion The malignancy rate of AUS/FLUS thyroid cytopathology at our center is in line with the risk of malignancy stated by the 2017 Bethesda System. However, our malignancy rate is lower than some other Canadian centers and approximately half of our rFNAs were re-classified, highlighting the importance of establishing center-specific malignancy and rFNA re-classification rates to guide treatment decisions.

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“…The fine-needle aspiration (FNA) is an accurate, cost-effective, minimally invasive procedure in the management of thyroid nodules and helpful in tailoring therapeutic decisions (1). Currently, the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is established to provide uniform terminology and criteria for the diagnosis of thyroid nodules and guide the clinical treatment.…”

Section: Introductionmentioning

confidence: 99%

The diversities in thyroid cytopathology practices among Asian countries using the Bethesda system for reporting thyroid cytopathology

Nguyen¹,

Truong²,

Kakudo³

et al. 2020

Gland Surg

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Background: The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) has been adopted and widely used among Asian countries. This study aims to investigate the application of TBSRTC in thyroid cytology practice among Asian countries Methods: We searched electronic databases including PubMed and Web of Science from 2010 to 2019.Meta-analysis of proportion and their 95% confidence intervals (CIs) were calculated using the randomeffect model. Meta-regression and subgroup analysis were used to search for heterogeneity origins.Results: We included 42 Asian studies with 84.953 fine-needle aspirations. Among six categories, benign was the most commonly diagnosed category. The resection rate (RR) and risk of malignancy (ROM) were highest in malignant and SM categories, and lowest among benign nodules. Thyroid cytology practice in Asia was characterized by a low RR and high ROM in patients with indeterminate thyroid nodules. There was a significant amount of heterogeneities of TBSRTC outputs (frequency, resection rate, and malignancy risk) among Asian countries. Meta-regression showed that the sources of heterogeneity might stem from the differences in study origin and the application of molecular testing. We highlighted the usefulness of preoperative molecular testing to select patients for surgery.Conclusions: Our study provided insight regarding thyroid cytology practice among Asian countries.Active surveillance is commonly used in Asian practice resulting in a low RR and high ROM for indeterminate nodules. There are still variations in general thyroid cytology practice in Asia. Future guidelines and consensus regarding the application of TBSRTC in thyroid cytology practice among Asian countries are required.

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A follow‐up study on thyroid aspirates reported as atypia of undetermined significance/follicular lesion of undetermined significance and follicular neoplasm/suspicious for follicular neoplasm: A multicenter study from the Arabian Gulf region

Abstract: The risk of malignancy for AUS/FLUS and FN/SFN are 29% and 45%, respectively. This risk of malignancy in our study is on the higher range of that reported in the literature.

Cited by 8 publications

References 44 publications

Thyroid nodules in the gulf: Renewed interest and ongoing debate

Thyroid nodules in the gulf: Renewed interest and ongoing debate

Rate of malignancy for thyroid nodules with AUS/FLUS cytopathology in a tertiary care center – a retrospective cohort study

The diversities in thyroid cytopathology practices among Asian countries using the Bethesda system for reporting thyroid cytopathology

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