Is the management of thyroid nodules and differentiated thyroid cancer in accordance with recent consensus guidelines? - Results of a national survey.
OBJECTIVE
To assess approaches to patients with a potentially malignant thyroid nodule and patients with differentiated thyroid carcinoma and compare them with the European Consensus and Guidelines by the American Thyroid Association.


METHODS
A survey of the 388 active members of the Belgian Thyroid Club.


METHODS
A questionnaire addressing the management of an index case and four clinical variations (including variations in the size of the tumour and histological type). The index case was a 40-year-old euthyroid woman with a 3-cm solitary thyroid nodule. Fine-needle aspiration (FNA) cytology showed cellular aspirates with numerous follicular cells and no colloid.


RESULTS
The overall response rate was 41%. For the index case, respondents favoured a right lobectomy. Variations in size and histopathology of the nodule altered the management. In the case of a papillary thyroid carcinoma (PTC) of 3 cm in diameter, a total thyroidectomy and prophylactic central lymph node dissection was preferred. After a lobectomy showing a 3.5-cm follicular thyroid carcinoma (FTC), completion surgery followed by radioiodine administration was the most frequent proposal. For the follow-up of the index case with a low-risk disease, determination of serum thyroglobulin (Tg) after recombinant human TSH (rhTSH) administration was considered by the majority of respondents. For the follow-up of a clinical variation with residual disease, immediate planning of a new treatment was (mistakenly) not considered by a majority of respondents.


CONCLUSIONS
In most cases, respondents were in accordance with the guidelines, although there were some unexpected variations.
Van den Bruel
A
A
Department of Internal Medicine/Endocrinology, AZ Brugge, Ruddershove 10, 8000 Brugge, Belgium. annick.vandenbruel@azbrugge.be
Moreno-Reyes
R
R
Bex
M
M
Daumerie
C
C
Glinoer
D
D
D000328:Adult; D001707:Biopsy, Needle; D005260:Female; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians'; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D013961:Thyroid Gland / Q000473:pathology*; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000628:therapy*; D016606:Thyroid Nodule / Q000473:pathology / Q000628:therapy; D013965:Thyroidectomy