{"doi":"10.1210/clinem/dgae108","title":"Indolent Behavior of Malignant Bethesda III Nodules Compared to Bethesda V/VI Nodules","abstract":"BACKGROUND: The Bethesda system classifies all fine-needle aspiration specimens into 1 of 6 categories. We speculated that cancers within each Bethesda category would have distinct clinical behavior. METHODS: This is a retrospective analysis of patients from a single academic medical center with a histologic diagnosis of thyroid cancer who had an initial diagnosis of Bethesda III, IV, V, or VI cytology. RESULTS: A total of 556 cases were included, with 87 cases of Bethesda III, 109 cases of IV, 120 cases of V, and 240 cases of VI. Bethesda III showed similarities with V/VI compared to IV with a predominance of papillary thyroid cancer. The interval from diagnosis to surgery was longer in Bethesda III compared to Bethesda V/VI (median 78 vs 41 days, P < .001) (Fig. 1). Yet, patients with Bethesda III had a higher probability of achieving remission (62% vs 46%, P < .03), a lower possibility of recurrence (8% vs 24%, P < .001), and a shorter interval to achieve remission (median 1218 vs 1682 days, P = .02) compared to Bethesda V/VI, which did not change after adjusting for age, sex, radioactive iodine therapy, mode of surgery, and tumor size. More than 70% of Bethesda III that later presented with recurrence had T3/T4 disease or distant metastasis. CONCLUSION: Cancers with Bethesda III cytology had a less aggressive clinical phenotype with better prognosis compared to V/VI despite histological similarities. The time to remission was shorter in Bethesda III despite a longer interval between diagnosis and surgery. The initial cytological diagnosis may guide management.","journal":"The Journal of Clinical Endocrinology & Metabolism","year":2024,"id":453388,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":8,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.6319,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1275919,"name":"Jing Peng","orcid":"0009-0006-8296-2052","position":1,"is_corresponding":false},{"id":447835,"name":"Fadi Nabhan","orcid":"0000-0003-3810-0050","position":2,"is_corresponding":false},{"id":1220469,"name":"Pamela Brock","orcid":"0000-0002-1549-5363","position":3,"is_corresponding":false},{"id":447832,"name":"Irina Azaryan","orcid":"0000-0002-0720-1302","position":4,"is_corresponding":false},{"id":447831,"name":"Clarine Long","orcid":"0000-0002-1059-5701","position":5,"is_corresponding":false},{"id":1276310,"name":"Laura E. Ryan","orcid":null,"position":6,"is_corresponding":false},{"id":14430,"name":"Matthew D. Ringel","orcid":"0000-0001-8672-3266","position":7,"is_corresponding":false},{"id":447834,"name":"Jennifer A. Sipos","orcid":"0000-0001-6745-7353","position":8,"is_corresponding":false},{"id":447830,"name":"Mayumi Endo","orcid":"0000-0002-7191-0314","position":0,"is_corresponding":true}],"reference_count":39,"raw_metadata":null,"created_at":"2026-07-19T02:02:58.784290Z","pmid":"38415340","pmcid":null,"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":[]}