The negative outlook: Long‐term follow up of ThyroSeq negative and low‐risk nodules

Abstract

AbstractBackgroundMolecular testing of thyroid nodules is an essential tool to help risk stratify nodules with indeterminate cytology. Although ThyroSeq testing has been around for over a decade, there is a paucity of long‐term follow‐up data on cytologically indeterminate nodules that are determined to be molecularly negative or low‐risk. The objective of this study is to assess the outcomes of nodules with indeterminate cytology (Bethesda III or IV) and negative or low‐risk ThyroSeq results.MethodsThis is a single academic institution retrospective cohort study. Patients with at least one thyroid nodule sampled with fine‐needle aspiration who underwent ThyroSeq testing from 2012 to 2018 and had negative or low‐risk ThyroSeq results on a cytologically indeterminate sample (n = 159 patients, 167 nodules) were included in the study. Outcomes include the false‐negative rate and negative predictive value of each test version, as well as follow‐up length for each nodule.ResultsThere were 159 patients with a mean age of 58 years (7–84 years) included in this study; the majority were female (81.8%). The mean follow‐up was 4.0 years. Of 167 nodules, three were found to be malignant on resection (1.8%). The negative predictive value for the entire cohort was 98.2% and it was 89.3% for the surgical series.ConclusionThyroSeq testing has good negative predictive value and can help risk stratify cytologically indeterminate nodules. Routine follow‐up allows for safe monitoring of nodules for features suggestive of malignancy.