ECE2020 Audio ePoster Presentations Thyroid (144 abstracts)
The natural history of benign thyroid nodules: 10 years follow-up
Valeria Ramundo 1 , Giorgio Grani 1 , Rocco Bruno 2 , Giuseppe Costante 3 , Domenico Meringolo 4 , Efisio Puxeddu 5 , Massimo Torlontano 6 , Salvatore Tumino 7 , Giuseppe Lucisano 8 , Antonio Nicolucci 8 , Sebastiano Filetti 1 & Cosimo Durante 1
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.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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