Five-year follow-up and clinical outcome in euthyroid patients with thyroid nodules

Five-year follow-up of thyroid nodules

Abstract

Objective. Thyroid nodule diagnosis has become increasingly frequent. Defining optimum surveillance intervals for patients with unsuspicious thyroid nodules remains a challenge.

Design. This was a single centre cohort study in which patients diagnosed with unsuspicious thyroid nodules in whom no treatment was indicated were invited for re-evaluation 5 years after the diagnosis.

Methods. Baseline patient parameters and ultrasound characteristics of the nodules were retrospectively collected. At follow-up, thyroid ultrasound was performed.

Results. A hundred and eighteen (107 women/11 men, aged 56.8 ±13.4 years) patients were included in the study, with a total of 229 nodules (203 at baseline with mean largest nodule diameter 10.5±7.4 mm, additional 26 identified at follow-up).

After 5 years, 58 (25.3 %) out of 229 nodules significantly increased in size, 27 (11.8%) decreased, and for 104 (45.4%) of nodules, no change in size was noted. Fourteen (6.1%) nodules disappeared and 26 (11.4%) new nodules were found.

Regarding the clinical outcome, no new thyroid cancers were found. For 107 (90.7%) patients no further management was indicated. Five (4.2%) patients were referred to thyroidectomy because of the growth of the nodules. Two (1.7%) patients were treated for hyperthyroidism. Four (3.4%) patients did not complete the study.

Conclusions. We report a single centre experience of the natural history of unsuspicious thyroid nodules. Our results show that 63.3% of such nodules remain stable in size, decrease or even disappear and that the vast majority of the patients remain clinically stable with no treatment indication 5 years after the diagnosis.