Endocrine Abstracts

Point mutations constitute the majority of thyroid cancer mutations. Depending on screening strategy and patient populations, however, rearrangements also serve as oncogenic drivers for roughly one-in-five tumors. This underscores the importance of a comprehensive molecular approach that extends beyond assessment of single nucleotide variants (SNV). Receptor tyrosine kinases (RTK) feature prevalently within the described gene fusions in thyroid entities. Such fusions impart a ...

Objective: Molecular test (MT) of cytologically indeterminate thyroid nodules (ITNs) needs to be appropriately focused on clinical situations where it can influence decision making. We therefore evaluated MT as an adjunct to an optimized integrated interdisciplinary thyroid nodule diagnostic pathway.Methods: 1024 consecutive ITNs were included, each underwent reflexive ThyroSPEC MT between July 30, 2020, and October 30, 2023. A multivariate regression mo...

Objectives: Molecular diagnostic tests for indeterminate thyroid nodules (ITNs) are marketed based on negative predictive value (NPV) and benign call rate. Arguments that unnecessary surgeries are avoided based on NPV/BCR incorrectly assume that all ITNs would undergo diagnostic surgery in the absence of molecular testing. In our practice with centralized triage and cytopathology the resection and malignancy rate, respectively, were 21% and 26% for AUS/FLUS and 56% and 43% for...

Objectives: Fine needle aspiration (FNA) cytology of highly prevalent thyroid nodules results in an indeterminate cytopathologic diagnosis in approximately 20% of cases. To better triage patients for diagnostic vs definitive thyroid surgery or to avoid diagnostic surgery, low-cost gene panels can be used as a rule-in molecular test. However, there remains a need to pre-surgically diagnose indeterminate thyroid nodules where somatic mutations are not identified. The ex...

Objective: The 2016 ATA RR assessment recommendations for patients with DTC were based on retrospective studies. We present the first outcomes of a prospective assessment of thyroid cancer management according to the ATA RR stratification.Methods: Using the Calgary prospective thyroid cancer database, we identified 612 patients with differentiated thyroid cancer (DTC) treated at our centre between April 2017 and December 2021. Each case was reviewed by t...