Impact of oncogene panel results on surgical management of cytologically indeterminate thyroid nodules

Pablo Valderrabano; Laila Khazai; Zachary J. Thompson; Marino E. Leon; Kristen J. Otto; Julie E. Hallanger-Johnson; J. Trad Wadsworth; Christine H. Chung; Barbara A. Centeno; Bryan McIver

doi:10.1002/hed.25165

Impact of oncogene panel results on surgical management of cytologically indeterminate thyroid nodules

Pablo Valderrabano, Laila Khazai, Zachary J. Thompson, Marino E. Leon, Kristen J. Otto, Julie E. Hallanger-Johnson, J. Trad Wadsworth, Christine H. Chung, Barbara A. Centeno, Bryan McIver

Research output: Contribution to journal › Article › peer-review

18 Scopus citations

Abstract

Background: The impact of oncogene panel results on the surgical management of indeterminate thyroid nodules (ITNs) is currently unknown. Methods: Surgical management of 649 patients consecutively evaluated from October 2008 to April 2016 with a single nodule biopsied and indeterminate cytology (193 evaluated with and 456 without oncogene panels) was assessed and compared. Histological features of 629 consecutively resected ITNs (164 evaluated with and 465 without oncogene panels) were also characterized and compared. Results: Oncogene panel evaluation was associated with higher rates of total thyroidectomy (45% vs 28%; P =.006), and central lymph node dissection (19% vs 12%; P =.03) without increasing the yield of malignancy or decreasing the rate of completion thyroidectomy. Most malignancies (64%), including 83% of those with driver mutation identified, were low-risk cancers for which a lobectomy could have been sufficient initial treatment. Conclusion: Current oncogene panel results seem insufficient to guide the surgical extent of solitary ITNs.

Original language	English (US)
Pages (from-to)	1812-1823
Number of pages	12
Journal	Head and Neck
Volume	40
Issue number	8
DOIs	https://doi.org/10.1002/hed.25165
State	Published - Aug 2018
Externally published	Yes

Keywords

molecular marker tests
noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP)
thyroid cancer
thyroid nodule
thyroid surgery

ASJC Scopus subject areas

Otorhinolaryngology

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10.1002/hed.25165

Cite this

@article{00ef69a734cd428b90a82fee56b50098,

title = "Impact of oncogene panel results on surgical management of cytologically indeterminate thyroid nodules",

abstract = "Background: The impact of oncogene panel results on the surgical management of indeterminate thyroid nodules (ITNs) is currently unknown. Methods: Surgical management of 649 patients consecutively evaluated from October 2008 to April 2016 with a single nodule biopsied and indeterminate cytology (193 evaluated with and 456 without oncogene panels) was assessed and compared. Histological features of 629 consecutively resected ITNs (164 evaluated with and 465 without oncogene panels) were also characterized and compared. Results: Oncogene panel evaluation was associated with higher rates of total thyroidectomy (45% vs 28%; P =.006), and central lymph node dissection (19% vs 12%; P =.03) without increasing the yield of malignancy or decreasing the rate of completion thyroidectomy. Most malignancies (64%), including 83% of those with driver mutation identified, were low-risk cancers for which a lobectomy could have been sufficient initial treatment. Conclusion: Current oncogene panel results seem insufficient to guide the surgical extent of solitary ITNs.",

keywords = "molecular marker tests, noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP), thyroid cancer, thyroid nodule, thyroid surgery",

author = "Pablo Valderrabano and Laila Khazai and Thompson, {Zachary J.} and Leon, {Marino E.} and Otto, {Kristen J.} and Hallanger-Johnson, {Julie E.} and Wadsworth, {J. Trad} and Chung, {Christine H.} and Centeno, {Barbara A.} and Bryan McIver",

note = "Funding Information: This work has been supported in part by the Biostatistics Core Facility at the H. Lee Moffitt Cancer Center and Research Institute, a National Cancer Institute (NCI) designated comprehensive cancer center (P30-CA076292) Funding Information: This work has been supported in part by the Biostatistics Core Facility at the H. Lee Moffitt Cancer Center and Research Institute, a National Cancer Institute (NCI) designated comprehensive cancer center (P30-CA076292). Publisher Copyright: {\textcopyright} 2018 Wiley Periodicals, Inc.",

year = "2018",

month = aug,

doi = "10.1002/hed.25165",

language = "English (US)",

volume = "40",

pages = "1812--1823",

journal = "Head and Neck",

issn = "1043-3074",

publisher = "Wiley-Liss Inc.",

number = "8",

}

TY - JOUR

T1 - Impact of oncogene panel results on surgical management of cytologically indeterminate thyroid nodules

AU - Valderrabano, Pablo

AU - Khazai, Laila

AU - Thompson, Zachary J.

AU - Leon, Marino E.

AU - Otto, Kristen J.

AU - Hallanger-Johnson, Julie E.

AU - Wadsworth, J. Trad

AU - Chung, Christine H.

AU - Centeno, Barbara A.

AU - McIver, Bryan

N1 - Funding Information: This work has been supported in part by the Biostatistics Core Facility at the H. Lee Moffitt Cancer Center and Research Institute, a National Cancer Institute (NCI) designated comprehensive cancer center (P30-CA076292) Funding Information: This work has been supported in part by the Biostatistics Core Facility at the H. Lee Moffitt Cancer Center and Research Institute, a National Cancer Institute (NCI) designated comprehensive cancer center (P30-CA076292). Publisher Copyright: © 2018 Wiley Periodicals, Inc.

PY - 2018/8

Y1 - 2018/8

N2 - Background: The impact of oncogene panel results on the surgical management of indeterminate thyroid nodules (ITNs) is currently unknown. Methods: Surgical management of 649 patients consecutively evaluated from October 2008 to April 2016 with a single nodule biopsied and indeterminate cytology (193 evaluated with and 456 without oncogene panels) was assessed and compared. Histological features of 629 consecutively resected ITNs (164 evaluated with and 465 without oncogene panels) were also characterized and compared. Results: Oncogene panel evaluation was associated with higher rates of total thyroidectomy (45% vs 28%; P =.006), and central lymph node dissection (19% vs 12%; P =.03) without increasing the yield of malignancy or decreasing the rate of completion thyroidectomy. Most malignancies (64%), including 83% of those with driver mutation identified, were low-risk cancers for which a lobectomy could have been sufficient initial treatment. Conclusion: Current oncogene panel results seem insufficient to guide the surgical extent of solitary ITNs.

AB - Background: The impact of oncogene panel results on the surgical management of indeterminate thyroid nodules (ITNs) is currently unknown. Methods: Surgical management of 649 patients consecutively evaluated from October 2008 to April 2016 with a single nodule biopsied and indeterminate cytology (193 evaluated with and 456 without oncogene panels) was assessed and compared. Histological features of 629 consecutively resected ITNs (164 evaluated with and 465 without oncogene panels) were also characterized and compared. Results: Oncogene panel evaluation was associated with higher rates of total thyroidectomy (45% vs 28%; P =.006), and central lymph node dissection (19% vs 12%; P =.03) without increasing the yield of malignancy or decreasing the rate of completion thyroidectomy. Most malignancies (64%), including 83% of those with driver mutation identified, were low-risk cancers for which a lobectomy could have been sufficient initial treatment. Conclusion: Current oncogene panel results seem insufficient to guide the surgical extent of solitary ITNs.

KW - molecular marker tests

KW - noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP)

KW - thyroid cancer

KW - thyroid nodule

KW - thyroid surgery

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JO - Head and Neck

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ER -

Impact of oncogene panel results on surgical management of cytologically indeterminate thyroid nodules

Abstract

Keywords

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