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Correlating the Bethesda System for Reporting Thyroid Cytopathology with Histology and Extent of Surgery: A Review of 21,746 Patients from Four Endocrine Surgery Registries Across Two Continents.
Inabnet, William B; Palazzo, Fausto; Sosa, Julie Ann; Kriger, Joshua; Aspinall, Sebastian; Barczynski, Marcin; Doherty, Gerard; Iacobone, Maurizio; Nordenstrom, Erik; Scott-Coombes, David; Wallin, Goran; Williams, Lauren; Bray, Rachel; Bergenfelz, Anders.
Afiliação
  • Inabnet WB; Department of Surgery, University of Kentucky College of Medicine, 800 Rose St, MN 268, Lexington, KY, 40536, USA. william.inabnet@uky.edu.
  • Palazzo F; Hammersmith Hospital and Imperial College, London, UK.
  • Sosa JA; University of California, San Francisco, CA, USA.
  • Kriger J; Columbia University Mailman School of Public Health, New York, NY, USA.
  • Aspinall S; Aberdeen Royal Infirmary, Aberdeen, Scotland, UK.
  • Barczynski M; Department of Endocrine Surgery, Third Chair of General Surgery, Jagiellonian University Medical College, Krakow, Poland.
  • Doherty G; Brigham and Women's Hospital, Boston, MA, USA.
  • Iacobone M; University of Padua, Padua, Italy.
  • Nordenstrom E; Lund University, Lund, Sweden.
  • Scott-Coombes D; University Hospital of Wales, Cardiff, UK.
  • Wallin G; Örebro University, Örebro, Sweden.
  • Williams L; Columbia University Mailman School of Public Health, New York, NY, USA.
  • Bray R; Columbia University Mailman School of Public Health, New York, NY, USA.
  • Bergenfelz A; Lund University, Lund, Sweden.
World J Surg ; 44(2): 426-435, 2020 Feb.
Article em En | MEDLINE | ID: mdl-31690953
BACKGROUND: The Bethesda system for cytopathology (TBSRTC) is a 6-tier diagnostic framework developed to standardize thyroid cytopathology reporting. The aim of this study was to determine the risk of malignancy (ROM) for each Bethesda category. METHODS: Thyroidectomy-related data from 314 facilities in 22 countries were entered into the following outcome registries: CESQIP (North America), Eurocrine (Europe), SQRTPA (Sweden) and UKRETS (UK). Demographic, cytological, pathologic and extent of surgery data were mapped into one dataset and analyzed. RESULTS: Out of 41,294 thyroidectomy patient entries from January 1, 2015, to June 30, 2017, 21,746 patients underwent both thyroid FNA and surgery. A comparison of cytology and surgical pathology data demonstrated a ROM for Bethesda categories 1 to 6 of 19.2%, 12.7%, 31.9%, 31.4%, 77.8% and 96.0%, respectively. Male patients had a higher rate of malignancy for every Bethesda category. Secondary analysis demonstrated a high ROM in male patients with Bethesda 3 category aged 31-35 years (52.1%, 95% confidence interval (CI) 37.9-66.2%), aged 36-40 years (55.9%, 95% CI 39.2-72.6%) and aged 41-45 years (46.9%, 95% CI 33-60.9%). Patients with Bethesda 5 and 6 scores were more likely to undergo total thyroidectomy (65.9% and 84.6%); for patients with Bethesda scores 2 and 3, a higher percentage of females underwent total thyroidectomy compared to males in spite of a higher ROM for males. CONCLUSIONS: These data demonstrate that Bethesda categories 1-4 are associated with a higher ROM compared to the first edition of TBSRTC, especially in male patients, and validate findings from the second edition of TBSRTC.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Glândula Tireoide / Tireoidectomia Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Glândula Tireoide / Tireoidectomia Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2020 Tipo de documento: Article