The value of preoperative molecular testing in the management of Bethesda V and Bethesda VI thyroid tumors.

Autor: Paspala A; Department of Surgery, Evgenideio Hospital, Papadiamantopoulou 20, Athens, 115 28, Greece. garoufalo@hotmail.com., Bompetsi G; 3rd Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece., Paschou SA; Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, School of Medicine, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece., Charalambopoulos A; 3rd Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece., Pikoulis E; 3rd Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece., Peppa M; Endocrine Unit, 2nd Propaedeutic Department of Internal Medicine & Research Institute, National & Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece., Nastos C; 3rd Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece.
Jazyk: angličtina
Zdroj: Hormones (Athens, Greece) [Hormones (Athens)] 2024 Sep 03. Date of Electronic Publication: 2024 Sep 03.
DOI: 10.1007/s42000-024-00597-0
Abstrakt: The incidence of thyroid cancer has increased over recent years due to the fact that several diagnostic tools, such as neck ultrasound and fine-needle aspiration, are being ever more widely adopted. Lately, another modality which might provide significant information preoperatively on the aggressiveness of a thyroid tumor, its prognosis, and its recurrence rate is molecular testing. We reviewed the literature with regard to the role of preoperative molecular testing in patients with Bethesda V and Bethesda VI thyroid nodules and its impact on choice of the optimal treatment strategy. Several molecular mutations and alterations are associated with thyroid cancer and its biological behavior, such as BRAF-V600E, RET, and TERT promoter. Although the value of preoperative molecular testing for indeterminate nodules (Bethesda III and Bethesda IV) have been analyzed in numerous studies, the impact of preoperative molecular testing on Bethesda V and Bethesda VI thyroid nodules is not adequately described in the current literature. The preoperative recognition of specific molecular mutations, such as BRAFV600E and TERT promoter mutation, might provide more individualized management for thyroid cancer patients by altering the surgical approach and the extent of surgery for patients diagnosed with a more aggressive or iodine-resistant subtype of thyroid cancer.Thyroid cancer is characterized by multiple genetic mutations and alterations and, as a result, preoperative molecular testing of malignant nodules could be a very useful tool for surgeons, enabling them to decide on the most appropriate surgical approach for each patient.
(© 2024. The Author(s), under exclusive licence to Hellenic Endocrine Society.)
Databáze: MEDLINE
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