Bethesda III and IV Thyroid Nodules Managed Nonoperatively After Molecular Testing With Afirma Gene Sequencing Classifier (GSC) or Thyroseq v3
Authors' conclusion
The majority of Bethesda III/IV thyroid nodules with negative or benign molecular test results are stable over 3 years of follow-up. These findings support the high sensitivity of current molecular tests and their role in ruling out malignancy in indeterminate thyroid nodules.
Study context
- Population
- Consecutive participants with Bethesda III and IV cytology on thyroid biopsy, University of California, Los Angeles (UCLA) health system, August 2017 to November 2019; indeterminate nodules with negative or benign molecular test results
- Participants
- 176 nodules
- Comparison
- Afirma GSC vs Thyroseq v3 in Bethesda III/IV nodules managed after negative or benign molecular testing
- Primary endpoint
- False negative rate of molecular testing
Primary result
As reported in the abstract
median surveillance 34 months (range 12-60 months)
Overall false negative rate
0.6%
Malignancies among 15 nodules resected during surveillance
1
Further findings
Immediate resection of nodules with negative or benign molecular test results
- Nodules undergoing immediate resection
- 14 (8%)
- Malignancies found on surgical pathology after immediate resection
- none
Nonoperative management with active surveillance · median surveillance 34 months (range 12-60 months)
- Nodules under active surveillance
- 162 (92%)
- Lost to follow-up
- 44 patients
- Nodules resected during surveillance
- 15
- Malignancies found among nodules resected during surveillance
- 1
Original publication
Bethesda III and IV Thyroid Nodules Managed Nonoperatively After Molecular Testing With Afirma GSC or Thyroseq v3. J Clin Endocrinol Metab. Published 30 March 2023. doi:10.
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