Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2016) 41 EP1122 | DOI: 10.1530/endoabs.41.EP1122

ECE2016 Eposter Presentations Thyroid cancer (81 abstracts)

A study on age and nodule size in affecting decision for repeat thyroid FNAC after one benign cytology

Seong Keat Cheah 1, , Brian Pierce 2 , Anusha Kumar 1, , Tommy Kyaw Tun 1, , Seamus Sreenan 1, , John McDermott 1, , Neil Hickey 2 , Eamon Leen 2 , Muna Sabah 2 & Thomas Walsh 2


1Royal College of Surgeons in Ireland, Dublin, Ireland; 2Connolly Hospital Blanchardstown, Dublin, Ireland.


Introduction: Fine needle aspiration cytology (FNAC) is a widely adopted pre-operative investigatory tool for thyroid nodules. The British Thyroid Association (BTA) recently updated guidelines recommending that an FNAC that initially yields benign cytology (Thy2) should be repeated if there is any clinical or ultrasound (US) suspicion (1). We postulate that there is a tendency for a more conservative approach in older age groups with smaller thyroid nodules on US studies.

Method: From our multidisciplinary meeting (MDM) database for thyroid nodules under investigation from 2012–2015, we identified 126 cases with a single Thy2 cytology. Cases were recommended for clinical or US surveillance, repeat FNAC or surgery. The mean age and nodule size was compared for the group recommended a more conservative approach (clinical or US surveillance) and the group recommended repeat FNAC or surgery. The mean difference was examined and independent t-test applied.

Results: The group recommended for US (36 cases, 29%) or clinical surveillance (28 cases, 22%) has a mean age of 56.7±16.7 years with a mean nodule size of 25.1±15.2 mm (data are mean ± standard deviation). The group recommended for surgery (9 cases, 7%) or repeat FNAC (53 cases 42%) has a younger mean age of 47±15.2 years with a larger mean nodule size at 33.7±15.2 mm. Between these groups, there is a mean difference of 9.7 years (P=0.001) for age and 8.5 mm for nodule size (P=0.002).

Conclusion: After one benign thyroid cytology, there is a tendency for a more conservative approach with US and clinical surveillance in older patients with smaller nodule size. From this study, the thresholds directing such decisions lie at approximately 50 years of age and a nodule size of 30 mm.

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