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Endocrine Abstracts (2020) 70 AEP860 | DOI: 10.1530/endoabs.70.AEP860

1Sapienza University of Rome, 1Department of Translational and Precision Medicine, Rome, Italy; 2Ospedale di Tinchi‐Pisticci, Endocrinology, Matera, Italy; 3Institut Jules Bordet Comprehensive Cancer Center, Bruxelles, Belgium; 4Ospedale di Bentivoglio, Bologna, Italy; 5Università di Perugia, Perugia, Italy; 6Istituto di Ricovero e Cura a Carattere Scientifico, Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy; 7Università di Catania, Catania, Italy; 8Coresearch, Pescara, Italy

Background and Aim: The incidental detection of asymptomatic thyroid nodules (TNs) has increased over time. Over 90% of newly diagnosed TNs are either cytologically or sonographically benign. This study aimed to determine the frequency and magnitude of changes in TNs size over time.

Methods: We performed a prospective, multicenter, observational study involving consecutive euthyroid patients with 1–4 asymptomatic, sonographically or cytologically benign TNs. The study cohort was recruited between 2006 and 2008. A yearly neck ultrasound was performed. TNs growth, defined as the first occurrence of volume increase during the follow-up, was considered significant if an increase of ≥ 20% was recorded in at least 2 diameters, with a minimum increase of 2 mm. After 10 years of follow-up, data were analyzed.

Results: 992 consecutive patients were enrolled, and 1567 TNs were evaluated. The median follow-up was 8 years (IQR 6.2–10 years). TNs growthoccurred in 356 patients (35.9%; 95% CI, 32.9–38.9). The median time to growth was 2 years (IQR 1–4 years). Stable nodules were reported in 578 patients (58.3%; 95% CI 55.2–61.3), while 58 patients had no growing TNs and/or at least a shrunk nodule (5.8%; 95% CI 4.4–7.3). New TNs (n = 456) appeared in 205 patients (20.7%; 95% CI 18.1–23.2). 242 (24.4%) patients finished the 10-years follow-up. Among these, the final nodule volume did not show a significant difference compared to baseline. 148 out of 242 patients showed a linear increase in TNs volume, mainly evident after the 3-years follow-up. Baseline factors associated with nodule growth were the same identified during the already published first 5-year analysis (multiple nodules, larger nodule baseline volume, male sex, age <45 years). However, the evidence of growth during the first 2 years follow-up was the strongest predictor of future growth (HR 7.43; 95% CI 5.82–9.48; P < 0.0001). Growing nodules had a median doubling time of 3 years, while the whole cohort had a median doubling time of 26.6 years.

Conclusions: A small fraction of nodules showed a significant size increase during 10 years of serial evaluation, and it is possible to predict their behavior with early (2 years) follow-up data. These findings allow us to estimate the interval of monitoring and support the view that patients with sonographically or cytologically benign TNs can be safely followed with less frequent examinations.

Volume 70

22nd European Congress of Endocrinology

05 Sep 2020 - 09 Sep 2020

European Society of Endocrinology 

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