Size of thyroid cancers does not correlate well with pre-operative thyroid nodule size on ultrasound
Year: 2025
Type: article
Study design: Observational Study
Abstract: Introduction Pre-operative thyroid ultrasound (TUS) helps risk-stratify patients with thyroid nodules. We evaluated the association between TUS size, pathologic papillary thyroid cancer (PTC) size, and extent of surgery pursued. Methods A single-institution retrospective analysis was performed on patients > 18 years of age with a pre-operative TUS from 2017 to 2022. Size comparisons were assessed using intra-class correlation (ICC). Results In total, 252 patients with 261 nodules were included. Two-hundred and twenty-one (84.7 %) nodules were PTC. The average maximum diameter of nodules was 0.77 cm (+/- 0.14 cm) on TUS and 1.40 cm (+/- 1.84 cm) on pathology for PTC < 1 cm (p-value 0.31); ICC 0.0. The average maximum diameter of nodules was 2.03 cm (+/- 0.78 cm) on TUS and 1.67 cm (+/- 1.13 cm) on pathology for PTC 1 – 4 cm (p = 0.001); ICC 0.30 (95 % CI 0.15 – 0.46). The average maximum diameter of nodules was 5.29 cm (+/- 1.21 cm) on TUS and 3.58 cm (+/- 2.36 cm) on pathology for PTC > 4 cm (p < 0.001); ICC 0.05 (95 % CI - 0.40 – 0.51). Fifteen patients (45.5 %) with a TUS nodule > 4 cm and pathological PTC less than or equal to 4 cm underwent a total thyroidectomy. Conclusions Pre-operative TUS of PTC > 1 cm overestimated the pathologic size of PTC. Nearly half of patients with a TUS nodule > 4 cm with pathologic PTC less than or equal to 4 cm underwent a total thyroidectomy. The size of nodules on pre-operative TUS should not dictate extent of thyroid resection alone.
Source: Surgical Oncology Insight
Authors: Adam Awe, Chris B. Agala, Anne Worth, Ellie R. Lee, Susan Maygarden, Jen Jen Yeh
Institution: University of North Carolina at Chapel Hill
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $2,300
OpenAlex ID: W7108611778