GEC Testing Does Not Affect Surgical Decision-making Process for Thyroid Nodules

Gene expression classifier (GEC) testing did not significantly affect the surgical decision-making process for patients with cytologically indeterminate thyroid nodules, a recent study published online ahead of print in JAMA Otolaryngology-Head & Neck Surgery has shown.¹

Commercial molecular testing like GEC is being used in the work-up of cytologically indeterminate thyroid nodules in order to help rule out malignancy in a thyroid nodule; however, its impact on surgical decision-making is not clear. 

Therefore, researchers sought to evaluate the effect and outcome of GEC test results on the decision-making process for patients with thyroid nodules who present for surgical consultation.

For the study, researchers analyzed data from 273 patients with thyroid nodules who had GEC test results who had presented for surgical consultation. Of those, 233 had suspicious test results, 31 had benign nodules, and 8 had indeterminate results. One patient had a positive GEC test result for medullary thyroid cancer.

The researchers found that the GEC test was correctly used as a rule-out test on 127 patients with indeterminate nodules who did not have a clinical indication to undergo an operation.

The study demonstrated that only 23 patients had an altered clinical management plan as a result of GEC test results, of which 16 were found to be inappropriately overtreated.

GEC testing did not impact the surgical decision-making process in 250 of the 273 patients and the test was used in 146 cases where it was not clinically indicated.

Reference

1. Noureldine S, Olson MT, Agrawal N, et al. Effect of gene expression classifier molecular testing on the surgical decision-making process for patients with thyroid nodules [published online ahead of print November 25, 2015]. JAMA Otolaryngol Head Neck Surg. doi: 10.1001/jamaoto.2015.2708.