Well differentiated thyroid carcinoma: Ten years' experience of one single institution

Abstract

5592 Background: During 1988–1997, 261 patients with well differentiated thyroid carcinoma were referred to our departments for further evaluation, treatment and follow up. Their files were retrospectively reviewed for treatment results analysis. After initial operation most patients had radioiodine ablation and suppressive thyroxine therapy and then were followed on a regular basis with serum Tg levels and WBS when indicated. Methods: 81% of patients were female and 19% male, their median age was 50 years (15–83), 40% were younger and 60% older than 45 years of age. 81% had papillary and 19% follicular carcinoma. 79% of younger patients had stage I disease (15% node positive) and 21% had stage II. 30 % of older patients had stage I disease, 43% had stage II, 18 % stage III (12% node positive) and 6% presented with metastatic disease. 91% of patients had total or near total thyroidectomy with lymph node resection if indicated. 72% had radioiodine ablative therapy, 30–100 mc according to post operative iodine uptake. Results: Median follow up was 119 months (51–187). 23 patients who achieved NED status at end of therapy recurred, median time to recurrence was 28 months (6–108) . The most common site of recurrence was cervical nodes (52%) followed by thyroid bed (26%) and distant metastases (22%). In 61% of patients the recurrent disease was diagnosed by clinical signs or symptoms and in 39% by regular Tg or WBS monitoring. 86% of patients are alive without evidence of disease, 4% are alive with disease (81–151 months from diagnosis, median 118), 5% died of disease (within 6–91 months from diagnosis, median 52 ) and 5% died of unrelated causes. 3% of papillary carcinoma patients and 16% of follicular carcinoma died of disease during the study period. Conclusions: We conclude that the presentation, stage distribution, histology subgroups and survival of well differentiated thyroid carcinoma patients in our institution is similar to other reported series. Regular follow up is warranted as recurrence may be late and it is usually detected at routine follow up visits. No significant financial relationships to disclose.