Selection of patients with solitary thyroid nodules for operation.
OBJECTIVE
To improve the preoperative selection for operation of patients with solitary thyroid nodules.


METHODS
Prospective cohort study.


METHODS
University hospital, France.


METHODS
155 consecutive patients who presented with solitary thyroid nodules and were operated on.


METHODS
Clinical examination, ultrasound examination, fine needle aspiration biopsy, followed by total thyroid lobectomy with frozen section and final histological examination.


METHODS
Correct prediction of thyroid carcinoma or benign adenoma.


RESULTS
A logistic regression analysis indicated that absence of rim (p < 0.002), solid and hypoechoic feature (p < 0.003) and malignant or suspicious fine needle aspiration biopsy results (p < 0.0001) were significantly associated with malignancy. Selection for operation by the logistic model would save 40 of 73 patients from operation and 40 of 59 from unnecessarily radical operation. It would detect a similar number of cancers as a strategy based solely on fine needle aspiration cytology.


CONCLUSIONS
A combination of the available diagnostic methods provides substantial benefit in the preoperative selection of patients with an isolated thyroid nodule.
Leenhardt
Laurence
L
Quantitative Medical Imaging Research Unit INSERM U494, Hĵpital Pitié-Salpêtrière, Paris, France.
Menegaux
Fabrice
F
Franc
Brigitte
B
Delbot
Thierry
T
Mansour
Georges
G
Hoang
Catherine
C
Guillausseau
Claudine
C
Aurengo
Helyett
H
Le Guillouzic
Danièle
D
Turpin
Gérard
G
Aurengo
André
A
Chigot
Jean Paul
JP
Hejblum
Gilles
G
D000231:Adenocarcinoma, Papillary / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D000236:Adenoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D000328:Adult; D001707:Biopsy, Needle; D018276:Carcinoma, Medullary / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016606:Thyroid Nodule / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy; D014463:Ultrasonography