RAS -Mutated Cytologically Indeterminate Thyroid Nodules: Prevalence of Malignancy and Behavior Under Active Surveillance
Authors' conclusion
We describe the behavior of RAS-mutant ITNs under AS and find that most demonstrate stability over time. Of the resected RAS-mutant nodules, most were benign; of the cancers, most were ATA low-risk.
Study context
- Population
- Cytologically indeterminate thyroid nodules (ITNs) with RAS mutations (HRAS, NRAS, KRAS)
- Participants
- 63 vs 209
- Exposure
- Active surveillance vs immediate surgery of RAS-mutant ITNs
- Active surveillance (AS)n = 63
- Immediate surgeryn = 209
- Outcome
- Cumulative incidence of nodule growth (≥72% change in tumor volume) under AS, Kaplan-Meier
Methodological detailstwo cohorts
- Two cohorts
Main finding
As reported in the abstract
Nodule growth under AS · median AS period 23 months (IQR 9.5-53.5 months)
| Group | Value | Cumulative incidence 1 year | Cumulative incidence 3 years | Cumulative incidence 5 years |
|---|---|---|---|---|
| AS | 19.0% | 1.9% | 23.0% | 28.0% |
AS
Value19.0%
Cumulative incidence 1 year1.9%
Cumulative incidence 3 years23.0%
Cumulative incidence 5 years28.0%
- Nodules demonstrating stability
- 81.0%
Observational data: associations, not effects.
Further findings
- Malignancy among AS nodules ultimately resected
- 16.7% · 1
- Malignancy among AS nodules ultimately resected — Nodules ultimately resected
- 6
- Malignancy in immediate surgery cohort
- 33%
- Disease-specific deaths, immediate surgery cohort · median follow-up 6.9 (IQR 4.4-7.1) years
- 0 · events
Original publication
RAS -Mutated Cytologically Indeterminate Thyroid Nodules: Prevalence of Malignancy and Behavior Under Active Surveillance. Thyroid. Published 28 March 2024. doi:10.
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