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LONG-TERM NONOPERATIVE RATE OF THYROID NODULES WITH BENIGN RESULTS ON THE AFIRMA GENE EXPRESSION CLASSIFIER.
Summary
A benign Afirma gene expression classifier (GEC) result reduced thyroid surgery rates in nonacademic settings. Physicians found GEC use safe, supporting nonoperative management for benign nodules.
Area of Science:
- Endocrinology
- Oncology
- Genetics
Background:
- Thyroid nodules are common, with fine-needle aspiration (FNA) cytology classifying many as indeterminate.
- Gene expression classifiers (GECs) aid in risk stratification of indeterminate thyroid nodules.
- The Afirma GEC is a tool used to assess the risk of malignancy in thyroid nodules.
Purpose of the Study:
- To evaluate the operative rate in patients with a benign Afirma GEC result at nonacademic medical facilities.
- To assess physician perception of the Afirma GEC's safety in managing thyroid nodules.
Main Methods:
- Retrospective study of nonacademic practices using the Afirma GEC.
- Included patients with at least 36 months of follow-up after a benign GEC result.
- Physician surveys assessed perceived safety of GEC use.
Main Results:
- 17.3% (17/98) of patients with a benign GEC result underwent surgery within 36 months.
- 88% of surgeries occurred within the first two years post-benign GEC result.
- 78% of physicians (78/91) felt GEC use improved patient safety.
Conclusions:
- A benign Afirma GEC result is associated with decreased thyroid surgery rates compared to historical data.
- Nonoperative management following a benign GEC result is considered safe by most physicians.
- The Afirma GEC aids in reducing unnecessary surgeries for benign thyroid nodules.
