Algorithm for timely diagnosis of thyroid cancer in the course of nodular thyroid disease
Keywords:
fine-needle biopsy, thyroid nodule, thyroid neoplasms, ultrasound, watchful waitingAbstract
Introduction: Timely diagnosis of thyroid cancer requires greater homogeneity, consistency, uniformity, and precision compared to the multiple guidelines that evaluate the risk stratification of malignancy in thyroid nodules.
Objective: To evaluate the feasibility of an algorithm for the timely diagnosis of thyroid cancer during the course of thyroid nodular disease.
Methods: Quasi-experimental study in patients with thyroid nodular disease. Two groups were formed and compared: group I (n = 42) not subjected to the algorithm, and group II
(n = 31) treated with the algorithm. Clinical, epidemiological, diagnostic, and therapeutic variables were evaluated. Inferential and survival statistical analyses were performed.
Results: Statistically significant differences were found in group II undergoing the algorithm with respect to: reduction in immediate surgeries (6.4% vs. 95.2%; p < 0.05); increase in active surveillance (93.6% vs. 4.8%; p < 0.05); increase in nodule evaluation time (56.5 vs. 7.6 months; p < 0.05); decrease in the percentage of patients with thyroid cancer (6.4% vs. 37.5%; p < 0.05), increase in event-free survival up to 41 months and surgery-free survival up to 56.5 months (p < 0.05).
Conclusion: The application of the algorithm allows for improved personalized timely diagnosis of TC during the course of NCDs by reducing the percentage of patients operated on for this condition, with the benefits of active surveillance.
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