{"doi":"10.1210/clinem/dgaa506","title":"Features of Cytologically Indeterminate Molecularly Benign Nodules Treated With Surgery","abstract":"BACKGROUND: Most cytologically indeterminate thyroid nodules (ITNs) with benign molecular testing are not surgically removed. The data on clinical outcomes of these nodules are limited. METHODS: We retrospectively analyzed all ITNs where molecular testing was performed either with the Afirma gene expression classifier or Afirma gene sequencing classifier between 2011 and 2018 at a single institution. RESULTS: Thirty-eight out of 289 molecularly benign ITNs were ultimately resected. The most common reason for surgery was compressive symptoms (39%). In multivariable modeling, patients aged <40 years, nodules ≥3 cm, presence of an Afirma suspicious nodule other than the index nodule, and compressive symptoms were associated with higher surgery rates with hazard ratios for surgery of 3.5 (P < 0.001), 3.2 (P < 0.001), 16.8 (P < 0.001), and 7.31 (P < 0.001), respectively. Of resected nodules, 5 were malignant. False-negative rate (FNR) was 1.7%, presuming all unresected nodules were truly benign and 13.2% restricting analysis to resected cases. The FNR was significantly higher in nodules with a high-risk sonographic appearance for cancer (American Thyroid Association high-risk classification and American College of Radiology Thyroid Imaging Reporting and Data Systems score of 5) compared with nodules with all other sonographic categories (11.8% vs 1.1%; P = 0.03 and 11.1% vs 1.1%; P = 0.02, respectively). CONCLUSIONS: Younger age, larger nodule size, presence of an Afirma suspicious nodule other than the index nodule, and compressive symptoms were associated with a higher rate of surgery. The FNR of benign Afirma was significantly higher in nodules with high-risk sonographic features.","journal":"The Journal of Clinical Endocrinology & Metabolism","year":2020,"id":88386,"datarank":0.5979055956213397,"base_score":2.3978952727983707,"endowment":2.3978952727983707,"self_citation_contribution":0.3596842909197557,"citation_network_contribution":0.238221304701584,"self_endowment_contribution":0.3596842909197557,"citer_contribution":0.238221304701584,"corpus_percentile":67.00703952966659,"corpus_rank":4266,"citation_count":10,"citer_count":9,"citers_with_citation_signal":5,"citers_with_endowment":5,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.5542,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":395865,"name":"Kyle Porter","orcid":"0000-0001-7581-1471","position":1,"is_corresponding":false},{"id":447831,"name":"Clarine Long","orcid":"0000-0002-1059-5701","position":2,"is_corresponding":false},{"id":447832,"name":"Irina Azaryan","orcid":"0000-0002-0720-1302","position":3,"is_corresponding":false},{"id":447833,"name":"John E. Phay","orcid":"0000-0002-8482-2137","position":4,"is_corresponding":false},{"id":14430,"name":"Matthew D. Ringel","orcid":"0000-0001-8672-3266","position":5,"is_corresponding":false},{"id":447834,"name":"Jennifer A. Sipos","orcid":"0000-0001-6745-7353","position":6,"is_corresponding":false},{"id":447835,"name":"Fadi Nabhan","orcid":"0000-0003-3810-0050","position":7,"is_corresponding":false},{"id":447830,"name":"Mayumi Endo","orcid":"0000-0002-7191-0314","position":0,"is_corresponding":true}],"reference_count":60,"raw_metadata":null,"created_at":"2026-07-18T22:00:56.736935Z","pmid":"32772084","pmcid":"PMC7497819","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}