Is the nodule location a predictive risk factor for cancer in AUS/FLUS thyroid nodules? A retrospective cohort study.

Autor:	Alqahtani SM; Department of Surgery, College of Medicine, Majmaah University, Riyadh-Qassim road, Al-Majmaah, 11952, Saudi Arabia. Electronic address: sm.alqahtani@mu.edu.sa., Altalhi BA; Department of Surgery, King Fahad Armed Forces Hospital, Al-Kornaish road, Jeddah, 21159, Saudi Arabia., Alalawi YS; Department of Surgery, King Salman Armed Forces Hospital Northwestern Region, King Abdul Aziz road, Tabuk, 71411, Saudi Arabia., Al-Sobhi SS; Department of Surgery, King Faisal Specialist Hospital & Research Center, Makkah road, Riyadh, 11211, Saudi Arabia.
Jazyk:	angličtina
Zdroj:	Asian journal of surgery [Asian J Surg] 2024 Jun; Vol. 47 (6), pp. 2574-2578. Date of Electronic Publication: 2024 Feb 28.
DOI:	10.1016/j.asjsur.2024.02.096
Abstrakt:	Background: Atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) is a heterogeneous category of thyroid nodules with uncertain cytology and controversial management. This study aimed to assess the association between nodule location and malignancy risk and whether the location can be used as a predictive risk factor for cancer in AUS/FLUS nodules. Methods: A cohort of 102 patients (79 [77.5%] women, 23 [22.5%] men) was retrospectively analyzed. Only patients with a final histopathology of benign or well-differentiated thyroid cancer and an available nodule location were included. Sociodemographic, histopathological, and sonographic data were statistically evaluated and correlated. Results: Based on pathology findings, 54 (52.9%) and 48 (47.1%) nodules were benign and malignant, respectively. Most nodules were right-sided (54.9%). Considering the nodule location, 41.2% of nodules occupied the whole lobe, 20.6% only the lower pole, 15.7% only the upper pole, and 2.9% the isthmus. Cases with nodules occupying only the upper, middle, or lower pole showed significant associations with cancer risk (odds ratio, [95% confidence interval]: 2.6, [1.1-5.7]; 2.0, [1.0-4.7]; and 1.9, [1.0-3.9], respectively). Male sex and the presence of a peripheral halo were significantly associated with malignancy risk (3.3, [1.2-9.1], P = 0.014; and 2.7, [1.0-9.5], P = 0.049, respectively). Isthmic nodules had the highest malignancy level (66.7%). Conclusions: Nodule location is a promising predictor of malignancy in AUS/FLUS nodules. Furthermore, isthmic nodules had the highest malignancy level, emphasizing the significance of careful evaluation of these nodules. Further large prospective studies are required to confirm these findings. Competing Interests: Declaration of competing interest The authors declare no conflict of interest. (Copyright © 2024 Asian Surgical Association and Taiwan Society of Coloproctology. Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
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