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Table 2 Time interval until first follow-up of a benign thyroid nodule and the risk of growth, repeat FNAs, thyroidectomies, malignancies and mortality

From: Long- versus short-interval follow-up of cytologically benign thyroid nodules: a prospective cohort study

Follow-up time, years

n

15 % Growth, % (n)

50 % Growth, % (n)

Repeat FNAs, % (n)

Outcomes of repeat FNAs

Thyroidectomies, % (n)

Indication for thyroidectomy

Malignancies, % (n)

Disease- related mortality, % (n)

0.5–1

489

30.3 (148)

8.6 (42)

5.1 (25)

21 Benign

1 AUS

3 Non-diagnostica

0.8 (4)

3 US Large size/growth

1 Compressive symptoms

0.2 (1)

0 (0)

>1–2

715

34.8 (249)

15.1 (108)

5.6 (40)

29 Benign

4 AUS

1 Susp. foll. neopl.

1 Susp. PTC

5 Non-diagnosticb

0.8 (6)

4 Abnormal repeat FNA

2 US Large size/growth

0.3 (2)

0 (0)

>2–3

249

40.2 (100)

19.7 (49)

8.8 (22)

18 Benign

1 AUS

1 Susp. foll. neopl.

1 Malignant

1 Non-diagnosticc

1.2 (3)

3 Abnormal repeat FNA

0.8 (2)

0 (0)

>3–4

143

50.3 (72)

34.3 (49)

18.9 (27)

22 Benign

3 AUS

2 Susp. foll. neopl.

4.9 (7)

3 Abnormal repeat FNA

2 Compressive symptoms

1 US Large size/growth

1 Afirma GEC positive

0.7 (1)

0 (0)

>4 (range 4.0–14.1)

223

52.5 (117)

35.0 (78)

19.3 (43)

35 Benign

3 AUS

1 Susp. Hurthle cell neopl.

1 Malignant

3 Non-diagnosticd

4.0 (9)

5 Compressive symptoms

2 Abnormal repeat FNA

1 US Large size/growth

1 Afirma GEC positive

0.4 (1)

0 (0)

P value

 

<0.0001

<0.0001

<0.0001

 

0.0001

 

0.77

  1. aAll nodules were >75 % cystic and had therefore a negligible low risk of malignancy and were not rebiopsied
  2. bThree nodules were >75 % cystic and had therefore a negligible low risk of malignancy and were not rebiopsied. One nodule did not change in size during follow-up, and was therefore not rebiopsied. One nodule was surgically removed (lobectomy) due to its large size (4.4 cm) and histological diagnosis confirmed a 3.3 cm follicular variant PTC (see Table 3 subject no. 3)
  3. cNodule did not change in size during follow-up, and was therefore not rebiopsied
  4. dOne nodule >75 % cystic and another 50–75 % cystic, which had therefore a negligible low risk of malignancy. The third nodule underwent total thyroidectomy as this patient had another nodule diagnosed with malignant cytology. Histopathology confirmed a 1.1 cm follicular variant PTC, while the nodule with the non-diagnostic biopsy was histologically confirmed to be benign
  5. FNA, Fine needle aspiration; AUS, Atypical cells of undetermined significance; PTC, Papillary thyroid carcinoma; GEC, Gene expression classifier. All malignancies were determined by histopathology and the malignancy percentage indicates the rate of malignancies for the respective follow-up time group