Score-based improvement of the indication for surgical treatment of thyroid lesions.

BACKGROUND: The prevalence of focal lesions in the thyroid is high in Germany. In 2018 about 70 000 thyroid surgeries were performed, although the malignancy rate of such findings is low. For this reason it is important to conduct an adequate selection of patients for whom surgery is indicated. AIM: The aim of our work was to validate the preoperative indication for surgery of thyroid lesions based on an independent, self-developed clinical score. PATIENTS AND METHODS: The patient data were evaluated retrospectively over the period 2013 to 2014. A prerequisite for inclusion was that the patients had carried out their complete treatment in domo. The multiparametic score was determined retrospectively and ranges from 3 to 15. The subjective improvement of symptoms (self-disclosure > 6 months postoperatively) and the presence of malignant histology were evaluated as positive outcome parameters. RESULTS: From a collective of 180 patients, 36 patients could be included, in whom all score-relevant parameters had been surveyed. The score distribution was 10 % score 3, 12.5 % score 4, 25 % score 5, 25 % score 6, 12.5 % score 7, 7.5 % score 8, 5 % score 9 and 2.5 % score 10. Using ROC analysis shows an AUC of 0.903, which is a very good differentiation. With a CUT-off score of 7 or higher, 86 % of patients have benefited from surgery. CONCLUSION: Our score with the parameters clinical complaints, sonographically defined size of the thyroid and the cytological result of a fine needle biopsy can lead to an improvement of the indication for surgical treatment of thyroid nodules.