Differentiated Thyroid Carcinoma

Abstract

Well-differentiated thyroid cancer (WDTC) is rising in incidence across the world over the past 3 decades. We aimed to evaluate the natural history and clinical outcome of differentiated thyroid carcinoma by a retrospective analysis of 249 patients treated at a single institution. A cohort of 249 patients who underwent thyroidectomy for WDTC in the last 10 years in Maadi Military Hospital was studied. Main outcome measures were clinical management at the diagnosis, survival, morbidity, and prognostic risk factors. Mean age at diagnosis was 44.7 (SD, 14.6) years, where 52.2% were 45 years or older. Females represent 70.7% (P = 0.01), with female-to-male ratio of 4.1:1. Near-total thyroidectomy was done in 70.7% of the cases where papillary cancer was found in 80.8% and node metastasis in 10.5%. Radioactive I (RA I) was given an all cases (dose range, 80-150 mCi) with ablation success rate of 79.2%. Locoregional recurrence and metastasis (lungs and bones) were found in 2% and 6.8%, respectively. Multivariate Cox regression analysis showed that the mean ablation dose of RA I (odds ratio, 1.045; 95% confidence interval, 0.936-1.1189; P = 0.01) and presence of remote deposits (odds ratio, 1.049; 95% confidence interval, 0.836-1.1189; P = 0.01) are the significant influential factor in ablation success rate and survival, respectively. Our data suggest that proper ablation dose of RA I and absence of remote metastasis are the powerful predictors for excellent outcome in WDTC patients.