Arechavaleta-Granell R, Rangel-Sánchez G, González-Villaseñor G, Escalante-Pulido M

Language: Spanish
References: 14
Page: 22-29
PDF size: 209.04 Kb.

ABSTRACT

Background: Thyroid cancer is the most frequent endocrine neoplasm and its incidence has increased in the past decade. The recurrence rate at 40 years is 35%, with the vast majority occurring within the first 10 years of follow up and 68% of them occurring locally in the neck. Objective: To describe the clinical characteristics, staging, histopathology, treatment and recurrence rate of differentiated thyroid carcinoma (DTC) in our Center. Material and methods: We reviewed the clinical charts of patients with DTC attending our clinic from March 2008 to January 2009. Clinical, imaging, biochemical, surgical, histopathological data were recorded and the information obtained from patients with and without recurrences was compared. Results: One hundred and thirty two patients were included, with a mean age of 43.8 ± 15 years; 114 were females and 18 males. Papillary carcinoma was his histopathological diagnosis in 94.7% and follicular cancer in 3.78%. Mean tumor size was 2.37 ± 1.92 cm. In 56.6% of the cases a total thyroidectomy had been performed. According to the TNM classification, 62.9% were stage I, 9.1% stage II, 8.3% stage III, 9.1% stage IV A, 0.8% stage IV B and 2.3% stage IV C. According to the MACIS classification, 53.8% were stage 1, 14.4% stage 2, 3% stage 3 and 3% stage 4. Permanent hypoparathyroidism was diagnosed in 28.8% of the patients. Follow up data was available in 104 subjects, 47 of which had a recurrence. More males were found in the group with recurrence (4 vs 12, p = 0.01); initial TNM and MACIS staging was more advanced in the group with recurrences (p = 0.005 and p = 0.03, respectively). Tumor size, as well as local and distant metastasis were more frequent in the group with recurrences. In the group without recurrences the mean tumor free survival was 4.8 ± 4.05 years. Conclusions: The high recurrence and complications rate are probably related to the large proportion of patients who were initially treated in peripheral hospitals by general surgeons without the indispensable skill and expertise in thyroid surgery.

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