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The Correlation of Age with Prognosis of Atypia of Undetermined Significance and Follicular Lesion of Undetermined Significance in Thyroid Nodules

Authors Kaliszewski K, Diakowska D, Rzeszutko M, Wojtczak B, Rudnicki J

Received 31 January 2021

Accepted for publication 10 March 2021

Published 8 April 2021 Volume 2021:13 Pages 3101—3111

DOI https://doi.org/10.2147/CMAR.S304686

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Sanjeev Srivastava


Krzysztof Kaliszewski,1 Dorota Diakowska,2 Marta Rzeszutko,3 Beata Wojtczak,1 Jerzy Rudnicki1

1Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Wroclaw 50-556, Poland; 2Department of Nervous System Diseases, Faculty of Health Science, Wroclaw Medical University, Wroclaw 51-618, Poland; 3Department of Pathomorphology, Wroclaw Medical University, Wroclaw 50-368, Poland

Correspondence: Krzysztof Kaliszewski
Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, Wroclaw 50-556, Poland
Email [email protected]

Purpose: Although some prognostic variables and risk factors for thyroid cancer (TC) are age-related, the association between age and the risk of TC in patients with thyroid nodules (TNs) assigned to atypia of undetermined significance (AUS) and follicular lesion of undetermined significance (FLUS) is poorly estimated. The aim of this study was to assess the histopathology of AUS/FLUS and the risk of TC according to the age of the patients at the time of AUS/FLUS diagnosis.
Patients and Methods: Among 5021 individuals treated for TNs at one institution from 2008 to 2018, 161 (3.2%) patients with 161 TNs assigned to the AUS/FLUS category (1 nodule per patient) were selected and stratified by age at initial diagnosis: < 55 years, 55– 75 years and > 75 years. Logistic regression analysis was used to estimate the association of age with the risk of TC diagnosis.
Results: Ninety-one (56.52%) patients < 55 years old, 58 (36.02%) patients 55– 75 years old, and 12 (7.45%) individuals > 75 years old were identified. There were 130 (80.7%) females and 31 (19.3%) males with a mean age of 50.6 ± 16.12 years. Among the evaluated TNs, 142 (88.2%) were ultimately diagnosed as benign, and 19 (11.8%) were diagnosed as malignant. Younger age in patients was significantly related to malignancy outcome (p=0.024 for age < 55 years). Patients aged 55– 75 years had a significantly lower risk of TC than the other age categories (p=0.040). The risks of high vascularity and fast tumor growth were significantly higher in the youngest category than in the other categories (age < 55 years old: p=0.045 and p=0.002, respectively).
Conclusion: Although patients with TNs classified as AUS/FLUS by ultrasound-guided fine needle aspiration biopsy (UG-FNAB) are not typically qualified for surgery, it is worth noting that younger patients with an AUS/FLUS diagnosis might be at a higher risk of TC.

Keywords: age, risk factors, AUS/FLUS, thyroid cancer, surgery

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