Gene Expression Classifier May Reduce Thyroid Surgery Rate

Medical practices that used a gene expression classifier to assess thyroid nodules experienced a reduction in the rate of thyroid surgeries, according to data presented at the 15th International Thyroid Congress and 85th Annual Meeting of the American Thyroid Association.

Jennifer Sipos, MD, associate professor of medicine and director at the Benign Thyroid Program and Division of Endocrinology, Diabetes, and Metabolism at The Ohio State University School of Medicine, said the Afirma Gene Expression Classifier (GEC) improved patient safety at these non-academic centers when compared with thyroid nodule management without the GEC system.

“The majority of clinicians felt that the use of the GEC improved patient safety compared to not using it,” Dr Sipos said in an email interview with Endocrinology Advisor. “We concluded that GEC testing is associated with a durable reduction in the rate of surgery that clinicians believe is safe when patients are followed for 36 months after a benign GEC result.”

Dr Sipos and colleagues retrospectively analyzed patients with thyroid nodules who underwent GEC testing between September 2010 and June 2014. Patients were followed for 36 months. The clinicians included in the study had obtained at least 3 or more benign results during the testing period. Demographic and operative status data were also recorded for patients who underwent GEC testing.

“A benign Afirma GEC result was associated with a low operative rate during long-term follow up in non-academic medical centers,” said Dr Sipos. “The majority of surgeries occurred in the first 12 months after the benign GEC test.”

Of the 98 patients who had a benign GEC result, 17 patients (17.3%) underwent surgery, and 88% of the surgeries occurred within 2 years of a benign result.

The treating physicians also completed a survey where they recorded their perceptions of the safety of using the GEC system in clinical practice. They noted that, in 78 of 91 cases (86%), there was an improvement in patient safety when compared with not using GEC testing.

Reference

1. Sipos J, Blevins T, Chamberlain Shea H, et al. Poster 838: Long-term Nonoperative Rate Of Thyroid Nodules With Benign Results On The Afirma Gene Expression Classifier. Presented at the 15th International Thyroid Congress and 85th Annual Meeting of the American Thyroid Association (ITC/ATA); October 18-23, 2015; Lake Buena Vista, Florida.