Abstract
Background The global incidence of thyroid cancer has increased significantly over the past decades. This study aims to review the clinical characteristics and treatment outcomes of thyroid cancer at the Tertiary Care Hospital in the Najran region of Saudi Arabia. Material and methods We conducted a retrospective study of 279 patients diagnosed with thyroid cancer at our hospital from March 2014 to December 2021. Clinicopathologic parameters were obtained from the patient's medical records and examined using univariate and multivariate Cox regression to identify independent predictive markers. Result The mean age was 42.8 ±14.5 years, and most cases were female (n= 203, 72.8%).Most cases (n=170, 60.9%) underwent total thyroidectomy. Additionally, lymph node dissection was performed in 28 (10.0%) cases.Localized disease, distant, and regional metastasis were observed in 214 (76.7%), 34 (12.2%), and 31 (11.1%), respectively. The neck lymph nodes and lungs were the most common metastasis regions in 19 (6.8%) and 11 (3.9%) cases, respectively.Papillary thyroid cancer and follicular thyroid cancers accounted for the majority of cases in 236 (84.6%) and 33 (11.8%), respectively. Adjuvant therapy, including radioactive iodine ablation, was reported in 51 (18.3%) and external beam radiotherapy in four (1.4%). Independent prognostic factors of overall mortality of thyroid carcinoma were older age (Hazard ratio (HR):1.05, 95% confidence interval (CI): 1.01-1.09, p=0.008), Diabetic mellitus (HR: 4.30, 95% CI: 1.11-16.62, p=0.035), pathologic subtype of follicular carcinoma (HR: 4.48, 95% CI: 1.07-18.73, p=0.040) or non-papillary thyroid carcinoma subtypes (HR: 12.56, 95% CI: 2.44-64.74, p=0.002), metastasis presentation (HR: 11.70, 95% CI: 3.30-41.46, p<0.001), pulmonary metastasis (HR: 27.92, 95% CI: 6.96-111.98, p<0.001), bone and liver metastasis (HR: 15.20, 95% CI: 1.70-135.98, p=0.015), tumor size >4 cm (HR:121.21, 95% CI: 15.33-958.34,p<0.001), and extrathyroidal extension (HR: 6.15, 95% CI: 1.59-23.77, p=0.009). Conclusion This study demonstrates that advanced age, the presence of diabetes, non-papillary thyroid carcinoma subtypes, metastatic disease, tumor size greater than 4 cm, and extrathyroidal extension are independently associated with a poorer prognosis in patients with thyroid carcinoma. To offer the finest modern care, a multidisciplinary approach should be employed when developing a tailored treatment strategy, considering relevant recommendations and stratification systems.
Published Version
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