Comment: Oncogene panels are costly tools that allow for risk-stratification of indeterminate thyroid nodules and theoretically may decrease the incidence of thyroid surgery for benign disease. The authors’ finding that the use of oncogene panels was in fact associated with higher rates of total thyroidectomy and central compartment neck dissection without an increasing yield of malignancy suggests that these costly tools may not have the intended effect on the management of indeterminate thyroid nodules. —Andres Bur, MD
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September 2018What is the impact of oncogene panel results on the surgical management of indeterminate thyroid nodules (ITNs)?
Bottom line
OP evaluation was associated with higher rates of total thyroidectomy and central lymph node dissection without increasing the yield of malignancy or decreasing the rate of completion thyroidectomy.
Background: Several molecular marker tests are commercially available to characterize thyroid nodules with indeterminate cytology. Rule-out tests may avoid unnecessary diagnostic surgery, while rule-in tests may avoid the need for a completion thyroidectomy by identifying cancer before a diagnostic procedure. Total thyroidectomies may put patients at higher surgical risks to gain no clinical benefit.