Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
Ann Surg Oncol. 2013 Oct;20(11):3484-90. doi: 10.1245/s10434-013-3076-5. Epub 2013 Jun 28.

Does bethesda category predict aggressive features in malignant thyroid nodules?

Author information

  • 1Division of Endocrine and Minimally Invasive Surgery, Department of Surgery, New York Presbyterian Hospital/Weill Cornell Medical College, New York, NY 10065, USA.

Abstract

BACKGROUND:

It has been speculated that the Bethesda Classification System for thyroid fine-needle aspirate (FNA) may be used to predict aggressive features among histologically proven malignancies. We sought to evaluate whether malignancies that were characterized as Bethesda category V or VI have more aggressive features than malignancies that were category III or IV.

METHODS:

A prospectively maintained database was reviewed to identify thyroid malignancies treated at a single center from 2004 to 2009. Only cancers that could be definitively matched to a preoperative FNA were included. Associations between Bethesda category, patient demographics, histopathologic findings, and outcomes were examined.

RESULTS:

A total of 360 cancers were analyzed: 73 (20 %) were Bethesda category III or IV and 287 (80 %) were category V or VI. The majority of Bethesda III and IV cancers were follicular variants of papillary thyroid carcinoma (fvPTC), whereas the majority of Bethesda V and VI cancers were classic PTC (52 and 67 %, respectively, p < 0.01). Extrathyroidal extension (30 vs. 16 %, p = 0.02), lymph node metastases (50 vs. 31 %, p = 0.05), and multifocality (51 vs. 37 %, p = 0.03) were more common among Bethesda V and VI nodules. However, when Bethesda III or IV classic PTC and fvPTC were compared to Bethesda V or VI cancers of the same histologic subtype, there were no differences in any features. Recurrence and overall survival were the same in all groups.

CONCLUSIONS:

Bethesda category may help to predict the most likely histologic subtype of thyroid cancer, but it does not have any prognostic significance once the histologic diagnosis is known.

PMID:
23812773
[PubMed - indexed for MEDLINE]
PMCID:
PMC4025924
Free PMC Article

Images from this publication.See all images (1)Free text

FIGURE 1
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Springer Icon for PubMed Central
    Loading ...
    Write to the Help Desk