Surgical Indication in Thyroid Nodules ≥4 cm: Do Larger Nodules Carry Higher Malignancy and Complication Risks?
Journal of Craniofacial Surgery, cilt.37, sa.1-2, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 37 Sayı: 1-2
- Basım Tarihi: 2026
- Doi Numarası: 10.1097/scs.0000000000012045
- Dergi Adı: Journal of Craniofacial Surgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
- Anahtar Kelimeler: Fine-needle aspiration biopsy, thyroid nodule, thyroid surgery
- Van Yüzüncü Yıl Üniversitesi Adresli: Evet
Özet
Objective: – The management of thyroid nodules is outlined in various clinical guidelines. While the American Thyroid Association guideline provides more systematic algorithms for thyroid nodules smaller than 4 cm in diameter, there is no consensus on the management of nodules ≥4 cm. This study aims to contribute to this topic by evaluating the clinical data of patients who underwent thyroidectomy for nodules measuring ≥4 cm. Methods: – This study included 199 patients who underwent thyroidectomy due to thyroid nodules measuring ≥4 cm in diameter. Patients were evaluated based on age, sex, preoperative, postoperative day 1, and at least 1-month postoperative calcium (Ca) and parathyroid hormone (PTH) levels, maximum nodule diameter, fine-needle aspiration biopsy (FNAB) status, and final pathology data. Results: – A total of 199 patients (28 men, 171 women; mean age: 46.52±13.82 y) were included in the study. Malignancy was identified in 17.6% of the cases. Nodule size was significantly larger in male patients (P=0.017) and in malignant lesions, particularly those ≥4 cm. FNAB was performed in 39.2% of the patients; there was no statistically significant association between FNAB performance and age group, sex, or pathology results. However, false-negative FNAB results were detected in 25% of malignant cases, indicating the limited sensitivity of FNAB, especially in nodules ≥4 cm. Conclusion: – Thyroid nodules measuring ≥4 cm may warrant surgical intervention regardless of whether FNAB was performed or reported as benign, due to their relatively higher rates of malignancy and associated complications.