{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T15:18:46Z","timestamp":1780499926952,"version":"3.54.1"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp;amp; Neck"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The global incidence of thyroid cancer has risen over recent decades, largely attributed to increased detection of thyroid nodules. This trend has raised concerns regarding overdiagnosis and overtreatment. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) plays a pivotal role in preoperative risk stratification, yet clinical decision\u2010making remains challenging in indeterminate categories (Bethesda III\u2013V), particularly in resource\u2010limited settings where molecular testing is unavailable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the risk of malignancy (ROM) for each TBSRTC category among patients who underwent thyroid surgery over a 10\u2010year period at a tertiary care center in India, and to compare these rates with the 2023 TBSRTC risk estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study analyzed fine\u2010needle aspiration cytology and histopathology data for all patients who underwent thyroid surgeries conducted between 2014 and 2024. ROM across TBSRTC categories was calculated and compared with established TBSRTC risk estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A 100% malignancy rate was observed in TBSRTC VI category, supporting the reliability of surgical decisions in this group. However, significantly higher malignancy rates were found in TBSRTC categories III (58.7%), IV (82.7%), and V (100%) compared to TBSRTC estimates (22%, 30%, and 74%, respectively). TBSRTC III nuclear had a significantly higher malignancy rate (70.0%) than TBSRTC III other (40.57%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Institution specific malignancy data enhances the clinical utility of TBSRTC and improves patient counseling, particularly in settings where molecular diagnostics are not feasible.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70191","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T09:21:32Z","timestamp":1770715292000},"page":"1737-1741","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Are We Operating Smarter? Risk of Malignancy Across Bethesda Categories\u2014A 10\u2010Year Institutional Experience"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8649-0287","authenticated-orcid":false,"given":"Shawn Joseph","family":"Thadathil","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgical Oncology VPS Lakeshore Hospital and Research Centre  Kochi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0512-5385","authenticated-orcid":false,"given":"Karunya Gopal","family":"Rajagopal","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgical Oncology VPS Lakeshore Hospital and Research Centre  Kochi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iona Leekha","family":"Mathew","sequence":"additional","affiliation":[{"name":"Department of Pathology VPS Lakeshore Hospital and Research Centre  Kochi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihir","family":"Mohan","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgical Oncology VPS Lakeshore Hospital and Research Centre  Kochi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Mary","family":"Thampi","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgical Oncology VPS Lakeshore Hospital and Research Centre  Kochi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sourabh","family":"Padmanabhan","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgical Oncology VPS Lakeshore Hospital and Research Centre  Kochi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7948-5754","authenticated-orcid":false,"given":"Abhijith","family":"George","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgical Oncology VPS Lakeshore Hospital and Research Centre  Kochi India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers17091429"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.18.2164"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1409841"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2023.0141"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/9615294"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2015.0020"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1203208"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2018.4616"},{"issue":"2","key":"e_1_2_10_10_1","article-title":"Pilot Results of a Cost\u2010Effective NGS Panel (\u2018Thyro Track\u2019) in a Thyroid Nodule\/Cancer Clinic","volume":"26","author":"Thakur D.","year":"2022","journal-title":"Indian Journal of Endocrinology and Metabolism"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000339959"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCP5N4MTHPAFXFB"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12902\u2010020\u20100530\u20109"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.10043"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijem.IJEM_635_18"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100042\u20101757776"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.4103\/mgmj.mgmj_36_23"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.76615"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.4103\/0970\u20109371.112650"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22955"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/aqy109"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2017.0419"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2024.0436"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.4103\/2230\u20108210.363719"}],"container-title":["Head &amp; Neck"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.70191","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hed.70191","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.70191","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T14:21:30Z","timestamp":1780496490000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hed.70191"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,10]]},"references-count":23,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/hed.70191"],"URL":"https:\/\/doi.org\/10.1002\/hed.70191","archive":["Portico"],"relation":{},"ISSN":["1043-3074","1097-0347"],"issn-type":[{"value":"1043-3074","type":"print"},{"value":"1097-0347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,10]]},"assertion":[{"value":"2025-09-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}