ETA2024 Poster Presentations Nodules (10 abstracts)
Predictive factors in patients rejected for radiofrequency ablation of cytologically benign thyroid nodules: an observational cohort study
Sylvie Daclin 1 , Gilles Russ 2 , Jean Guillaume Marchand 3 , Sylvain Poiree 4 , Ghander Cecile 5 , Malanie Roy 6 , Fabrice Menegaux 7 , Gaujoux Sebastien 6 , Nathalie Chereau 8 , Gabrielle Deniziaut 9 , Claude Bigorgne 4 , Camille Buffet 10 & Adrien Ben Hamou 11
1Thyroid Diseases and Endocrine Tumors Department, Pitié-Salpêtrière Hospital, Thyroid Tumors Clinical Research Group N 16, Sorbonne University, Cancer Institute, Paris, France, Paris, Paris, France; 2Thyroid and Endocrine Tumors, Institute of Endocrinology, Pitie Salpetriere Hospital, Sorbonne University, Paris, France; 3Cpi, Imagerie, Paris, France; 4Thyroid Diseases and Endocrine Tumors Department, Pitié-Salpêtrière Hospital, Thyroid Tumors Clinical Research Group N 16, Sorbonne University, Cancer Institute, Paris, France; 5Hôpital Pitié Salpêtrière, Paris, France; 6Thyroid Diseases and Endocrine Tumors Department, Pitié-Salpêtrière Hospital, Thyroid Tumors Clinical Research Group N 16, Sorbonne University, Cancer Institute, Paris, France, Paris, France; 7Endocrine Surgery, Pitié Salpetriere Hospital, University Paris Vi, Paris, France; 8Pitie Salpetriere, Endocrine Surgery, Paris, France; 9Pitié-Salpêtrière Hospital; 10Pitié Salpêtrière Hospital, Hôpitaux Universitaires Pitié Salpêtrière, Thyroid and Endocrine Tumor Unit, Paris, France; 11American Hospital of Paris, La Pitié-Salpêtrière, Neuilly-Sur-Seine, France
Introduction: Thyroid radiofrequency ablation (RFA) is now recommended as an alternative surgery for symptomatic benign nodules. However, there is some concern that a small but non negligible percentage of such cases can be carcinomas, despite two benign cytology results. Indications for RFA should be validated in a multidisciplinary approach and if feasible during multidisciplinary team meetings (MDTM). The aim of our study is to evaluate the rationale for a systematic validation of the indications by a MDTM and to determine if any clinical and ultrasound (US) features can lead to suspect a malignant histological diagnosis.
Patients and Methods: A retrospective observational study was conducted between January 2019 and December 2023. Patients referred for RFA of a benign nodule with two benign cytology results and whose records were rejected by the MDTM and underwent surgery were analyzed. Data were analyzed using R software.
Results: A total of 573 patients were presented at MDTM. One hundred and thirty-two patients (23%) were considered not eligible for RFA and referred for lobectomy (25% male, mean age 46 ±14 years-old, mean nodular volume 25 ±23 mL, 66% classified as EU-TIRADS 3 and 32% as EU-Tirads 4). Forty-nine patients (37%) underwent surgery and eight patients (16%) had a non-benign histology (4 NIFT-P; 1 oxyphilic cell tumor of uncertain malignant potential; 1 minimally invasive follicular carcinoma; 2 follicular variants of papillary carcinomas). Malignancy predictive factors could be associated to male sex, age under 35 years-old (in 75% of cases) and ultrasound nodular appearance (exclusively solid composition in all patients, EU-TIRADS 4 in 63% of cases).
Conclusion: Evaluating the indications for thyroid nodules radiofrequency ablation by a MDTM in an expert center can help to detect tumors not eligible to RFA for histological reasons, despite two benign cytology results. Age, sex and US pattern should be taken into account prior considering RFA of a supposedly benign thyroid nodule.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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