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Archives of endocrinology and metabolism
Mar 21, 2019;63 (4): 337-344.

Is thyroid nodule volume predictive for malignancy?

Nagihan Bestepe, Didem Ozdemir, Husniye Baser, Berna Ogmen, Nuran Sungu, Mehmet Kilic, Reyhan Ersoy, Bekir Cakir
Author Information
  1. Nagihan Bestepe: Ankara Ataturk Educational and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey.
  2. Didem Ozdemir: Yildirim Beyazit University, School of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey.
  3. Husniye Baser: Ankara Ataturk Educational and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey.
  4. Berna Ogmen: Ankara Ataturk Educational and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey.
  5. Nuran Sungu: Yildirim Beyazit University, School of Medicine, Department of Pathology, Ankara, Turkey.
  6. Mehmet Kilic: Yildirim Beyazit University, School of Medicine, Department of General Surgery, Ankara, Turkey.
  7. Reyhan Ersoy: Yildirim Beyazit University, School of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey.
  8. Bekir Cakir: Yildirim Beyazit University, School of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey.
PMID: 30916163 DOI: 10.20945/2359-3997000000113

Abstract

OBJECTIVE: We aimed to determine the roles of preoperative thyroid nodule diameter and volume in the prediction of malignancy.
SUBJECTS AND METHODS: The medical records of patients who underwent thyroidectomy between January 2007 and December 2014 were reviewed. The nodule diameters were grouped as < 1 cm, 1-1.9 cm, 2-3.9 cm and ≥ 4 cm, and volume was grouped as > 5 cm3, 5-9.9 cm3 and > 10 cm3. ROC (Receiver Operating Characteristic) curve analysis was performed to find the optimal cutoff value of diameter and volume that can predict malignancy.
RESULTS: There were 5561 thyroid nodules in 2463 patients. Five hundred and forty (9.7%) nodules were < 1 cm, 2,413 (43.4%) were 1-1.9 cm, 1,600 (28.8%) were 2-3.9 cm and 1,008 (18.1%) were ≥ 4 cm. Malignancy rates were 25.6%,10.6%, 9.7% and 8.5% in nodules < 1 cm, 1-1.9 cm, 2-3.9 cm and ≥ 4 cm, respectively. When classified according to volume, 3,664 (65.9%) nodules were < 5 cm3, 594 (10.7%) were 5-9.9 cm3 and 1,303 (23.4%) were ≥ 10 cm3. The malignancy rates were 12.7%, 11.4% and 7.8% for the nodules < 5 cm3, 5-9.9 cm3 and ≥ 10 cm3, respectively (p < 0.001). In ROC curve analysis, an optimal cutoff value for diameter or volume that can predict malignancy in all thyroid nodules or nodules ≥ 4 cm could not be determined.
CONCLUSION: In this surgical series, malignancy risk did not increase with increasing nodule diameter or volume. Although the volume of malignant nodules ≥ 4 cm was higher than that of benign nodules ≥ 4 cm, there was no optimal cutoff value. The diameter or volume of the nodule cannot be used to predict malignancy or decide on surgical resection.

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MeSH Term

Adenoma, Oxyphilic
Adolescent
Adult
Aged
Aged, 80 and over
Diagnosis, Differential
Female
Humans
Male
Middle Aged
Predictive Value of Tests
ROC Curve
Retrospective Studies
Risk Assessment
Thyroid Cancer, Papillary
Thyroid Neoplasms
Thyroid Nodule
Tumor Burden
Young Adult
Journal Article

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