5-year analysis of thyroidectomies; a retrospective clinicopathological assessment of papillary carcinoma of thyroid in a coastal urban area
Keywords:Clinicopathological Analysis, Papillary Carcinoma, Thyroidectomy
Background: The aim of our study was to analyse thyroidectomies done past 5 years on a clinico pathological basis. Additionally, we also wanted to study the presence and characteristics of papillary carcinoma of thyroid.
Methods: Retrospective analysis of 57 patients who underwent thyroidectomy from 2012 to 2017 performed by Department of General Surgery of Sri Ramachandra Medical College (Chennai, India) was done and checked for statistical significance.
Results: In this 5-year study of 57 thyroidectomies, 17 patients had papillary carcinoma of thyroid, 1 patient had anaplastic carcinoma and another patient had a thyroid metastasis with unknown primary. The nonmalignant 38 patients were studied separately. Regarding malignancy, 29.4% had micro carcinoma. 35.3% were in Stage I. 94.1% were in Grade I, 94.1% had no angioinvasion. 15 patients (88.2%) had negative capsule invasion and negative lympho vascular invasion. 4 patients (23.5%) had extra thyroid extension. The observed difference in the characteristics were statistically not significant (p>0.05). The odds ratio for micro carcinoma of thyroid was 0.364. Most common clinical diagnosis among patients with benign disease was multinodular goiter and 16 (40%) patients had total thyroidectomy. 82.5% of patients had microscopic nodules on histopathology. The association between the surgery type and clinical diagnosis was statistically significant (p<0.001).
Conclusions: Statistical significance was noted between surgery type and clinical diagnosis. Papillary carcinoma of thyroid is not rare even in non endemic areas. The odds ratio for micro carcinoma thyroid is not significant but it does exist and post surgery, regular follow up is important.
Alam Hannan S. The magnificent seven: a history of modern thyroid surgery. Int J Surg. 2006;4:187-91.
McGreevy PS, Miller FA. Biography of Theodor Kocher. Surgery. 1969;65:990.
Wang C, Crapo LM. The epidemiology of thyroid disease and implications for screening. Endocrinol Metab Clin N Am. 1997;26:189-218.
Burguera B, Gharib H. Thyroid incidentalomas: prevalence, diagnosis, significance, and management. Endocrinol Metab Clin N Am. 2000;29:187-203.
Yeung MJ, Serpell JW. Management of solitary thyroid nodule. Oncologist 2008;13:105-12.
Elliott MS, Gao K, Gupta R, Chua EL, Gargya A, Clark J. Management of incidental and non-incidental papillary thyroid microcarcinoma. J Laryngol Otol. 2013;127(Suppl 2):S17-S23.
Solares CA, Penalonzo MA, Xu M, Orellana E. Occult papillary thyroid carcinoma in postmortem species: prevalence at autopsy. Am J Otolaryngol. 2005;26:87‑90.
Yassa L, Cibas ES, Benson CB, Frates MC, Doubilet PM, Gawande AA, et al. Long‐term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation. Cancer Cytopathology. 2007;111(6):508-16.
Abdulmughni YA, Al-Hureibi MA, Al-Hureibi KA, Ghafoor MA, Al-Wadan AH, Al-Hureibi YA. Thyroid cancer in Yemen. Saudi Med J. 2004;25:55-59.
Pellegriti G, Scollo C, Lumera G, Regalbuto C, Vigneri R, Belfiore A. Clinical behavior and outcome of papillary thyroid cancers smaller than 1.5 cm in diameter: Study of 299 cases. J Clin Endo Meta. 2004;89:3713‑20.
Küçük NO, Tari P, Tokmak E, Aras G. Treatment for microcarcinoma of the thyroid-clinical experience. Clin Nucl Med. 2007;32:279-81.
Giordano D, Frasoldati A, Kasperbauer JL, Gabrielli E, Pernice C, Zini M, et al. Lateral neck recurrence from papillary thyroid carcinoma: predictive factors and prognostic significance. Laryngoscope. 2014.
Londero SC, Krogdahl A, Bastholt L, Overgaard J, Trolle W, Pedersen HB, et al. Papillary thyroid microcarcinoma in Denmark 1996-2008: a national study of epidemiology and clinical significance. Thyroid. 2013;23(9):1159-64.
Ardito G, Revelli L, Giustozzi E, Salvatori M, Fadda G, Ardito F, et al. Aggressive papillary thyroid microcarcinoma: prognostic factors and therapeutic strategy. Clin Nucl Med. 2013;38(1):25-8.
Untch BR, Palmer FL, Ganly I, Patel SG, Michael Tuttle R, Shah JP, et al. Oncologic outcomes after completion thyroidectomy for patients with well-differentiated thyroid carcinoma. Ann Surg Oncol. 2014;21(4):1374-8.
Nixon IJ, Ganly I, Patel SG, Palmer FL, Whitcher MM, Tuttle RM, et al. Thyroid lobectomy for treatment of well differentiated intrathyroid malignancy Surg. 2012;151(4):571-9.