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Negro R, Attanasio R, Grimaldi F, et al. A 2016 Italian Survey about Guidelines and Clinical Management of Thyroid Nodules. Eur Thyroid J. 2016;6(2):75-81doi: 10.1159/000453032.
Negro, R., Attanasio, R., Grimaldi, F., Frasoldati, A., Guglielmi, R., & Papini, E. (2017). A 2016 Italian Survey about Guidelines and Clinical Management of Thyroid Nodules. European thyroid journal, 6(2), 75-81. https://doi.org/10.1159/000453032
Negro, Roberto, et al. "A 2016 Italian Survey about Guidelines and Clinical Management of Thyroid Nodules." European thyroid journal vol. 6,2 (2017): 75-81. doi: https://doi.org/10.1159/000453032
Negro R, Attanasio R, Grimaldi F, Frasoldati A, Guglielmi R, Papini E. A 2016 Italian Survey about Guidelines and Clinical Management of Thyroid Nodules. Eur Thyroid J. 2017 Apr;6(2):75-81. doi: 10.1159/000453032. Epub 2016 Dec 29. PMID: 28589088; PMCID: PMC5422755.
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Eur Thyroid J. 2017 Apr;6(2):75-81. doi: 10.1159/000453032. Epub 2016 Dec 29.

A 2016 Italian Survey about Guidelines and Clinical Management of Thyroid Nodules.

European thyroid journal

Roberto Negro, Roberto Attanasio, Franco Grimaldi, Andrea Frasoldati, Rinaldo Guglielmi, Enrico Papini

Affiliations

  1. Division of Endocrinology, "V. Fazzi" Hospital, Lecce, Italy.
  2. Endocrinology Service, Galeazzi Institute IRCCS, Milan, Italy.
  3. Endocrinology and Metabolic Disease Unit, Azienda Ospedaliero-Universitaria "S. Maria della Misericordia," Udine, Italy.
  4. Division of Endocrinology, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
  5. Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy.

PMID: 28589088 PMCID: PMC5422755 DOI: 10.1159/000453032

Abstract

BACKGROUND: While thyroid nodules are frequent in endocrine clinical practice, patients are often asymptomatic and euthyroid, and death is rare in cases of malignancy.

OBJECTIVES: To evaluate the perception of current international guidelines regarding thyroid nodule management among Italian endocrinologists, and to compare daily clinical practice with suggested recommendations.

METHODS: Italian Association of Clinical Endocrinologists (AME) members were invited to participate in a Web-based survey.

RESULTS: A total of 566 physicians responded. About 50% had read the full text of the guidelines. Over half appreciated the suggested ultrasound (US) risk categories. Fine-needle aspiration (FNA) was obtained more frequently than recommended. Follow-up of a cytologically benign nodule was largely performed according to the guidelines. Molecular testing would be most commonly requested when cytology reports showed atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) (TIR3A for Italian System). Iodine and/or levothyroxine were largely prescribed for cytologically benign asymptomatic nodules. Laser/radiofrequency ablation and percutaneous ethanol injection were commonly considered as alternatives to surgery (46.2 and 71.4%, respectively).

CONCLUSIONS: Efforts are needed to make the guidelines more user-friendly and to encourage the use of codified risk categories in thyroid US reports. FNA indications remain a matter of debate as FNA is obtained in clinical practice more often than is recommended. Current US follow-up modalities for a benign nodule are correct, but probably could be performed less frequently without any harm. Molecular testing, if accessible, would be helpful in guiding clinicians' strategies in cases of AUS/FLUS-TIR3A cytologic results. Nonsurgical procedures are favorably embraced.

Keywords: Cytology; Fine-needle aspiration; Guidelines; Thyroid nodule; Ultrasound

References

  1. BMC Endocr Disord. 2015 Nov 26;15:73 - PubMed
  2. Eur Thyroid J. 2012 Jul;1(2):110-7 - PubMed
  3. J Clin Endocrinol Metab. 2010 Mar;95(3):1365-9 - PubMed
  4. Cochrane Database Syst Rev. 2014 Jun 18;(6):CD004098 - PubMed
  5. JAMA. 2006 May 10;295(18):2164-7 - PubMed
  6. Thyroid. 2015 Mar;25(3):300-7 - PubMed
  7. N Engl J Med. 2012 Aug 23;367(8):705-15 - PubMed
  8. J Clin Endocrinol Metab. 2003 Dec;88(12 ):5773-7 - PubMed
  9. J Clin Endocrinol Metab. 2016 Jul;101(7):2853-62 - PubMed
  10. Eur Thyroid J. 2014 Sep;3(3):154-63 - PubMed
  11. JAMA. 2015 Mar 3;313(9):926-35 - PubMed
  12. J Clin Endocrinol Metab. 2009 Jun;94(6):2092-8 - PubMed
  13. Diagn Cytopathol. 2008 Jun;36(6):425-37 - PubMed
  14. J Clin Endocrinol Metab. 2013 Oct;98(10):3949-57 - PubMed
  15. J Clin Endocrinol Metab. 2014 Oct;99(10 ):3653-9 - PubMed
  16. Thyroid. 2016 Jan;26(1):1-133 - PubMed
  17. J Thyroid Res. 2014;2014:459791 - PubMed
  18. J Clin Endocrinol Metab. 2015 Dec;100(12):4563-9 - PubMed
  19. Thyroid. 2016 Jun;26(6):836-42 - PubMed
  20. Endocr Pract. 2016 May;22(5):622-39 - PubMed
  21. Thyroid. 2004 Dec;14(12):1056-60 - PubMed
  22. Thyroid. 2015 Aug;25(8):890-6 - PubMed
  23. Endocr Pract. 2004 May-Jun;10 (3):269-75 - PubMed
  24. Int J Hyperthermia. 2016 Nov;32(7):822-8 - PubMed
  25. Best Pract Res Clin Endocrinol Metab. 2014 Aug;28(4):545-57 - PubMed
  26. Thyroid. 2004 Feb;14(2):125-31 - PubMed
  27. J Ultrasound. 2009 Sep;12(3):107-11 - PubMed
  28. J Endocrinol Invest. 2014 Jun;37(6):593-9 - PubMed
  29. J Clin Endocrinol Metab. 2011 Nov;96(11):3390-7 - PubMed
  30. Eur J Clin Invest. 2009 Aug;39(8):699-706 - PubMed
  31. Clin Endocrinol (Oxf). 1977 Dec;7(6):481-93 - PubMed
  32. Best Pract Res Clin Endocrinol Metab. 2014 Aug;28(4):601-18 - PubMed

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