Indolent Behavior of Malignant Bethesda III Nodules Compared to Bethesda V/VI Nodules
Authors' conclusion
Cancers with Bethesda III cytology had a less aggressive clinical phenotype with better prognosis compared to V/VI despite histological similarities. The time to remission was shorter in Bethesda III despite a longer interval between diagnosis and surgery. The initial cytological diagnosis may guide management.
Study context
- Population
- Patients with histologic diagnosis of thyroid cancer and initial Bethesda III, IV, V or VI cytology, single academic medical center
- Participants
- 556 cases
- Exposure
- Malignant Bethesda III vs Bethesda V/VI nodules
- Bethesda IIIn = 87
- Bethesda IVn = 109
- Bethesda Vn = 120
- Bethesda VIn = 240
- Outcome
- Remission, recurrence and time to remission
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
- Bethesda III vs Bethesda V/VI: P < 0.03
- Bethesda III vs Bethesda V/VI: P < 0.001
- Bethesda III vs Bethesda V/VI: P = 0.02
- Unchanged after adjusting for age, sex, RAI therapy, mode of surgery and tumor size
Observational data: associations, not effects.
Further findings
Interval from diagnosis to surgery · longer with Bethesda III
P < 0.001
Recurrent Bethesda III with T3/T4 disease or distant metastasis
- Bethesda III with later recurrence that had T3/T4 disease or distant metastasis
- More than 70%
Histology
- Bethesda III similar to V/VI vs IV, with predominance of PTC
Original publication
Indolent Behavior of Malignant Bethesda III Nodules Compared to Bethesda V/VI Nodules. J Clin Endocrinol Metab. Published 28 February 2024. doi:10.
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