Material and methods: Retrospective review of patients with thyroid cancer at our hospital from 1999 to 2011 was done.
Results: Mean age at presentation was 44±17 years with female to male ratio of 2.1:1. Patients were followed for mean of 6.45 and median of 6 years. Out of 206 patients, 158 had differentiated thyroid carcinoma. Most common variant was papillary (n=130, 63.10%) followed by follicular carcinoma (n=22, 8.73%). 6 (2.91%) had hurthle cell variant of follicular carcinoma. 18 (8.73%) had medullary and 10 (4.85%) had anaplastic carcinoma. 20 (9.70%) patients had other causes like carcinoma of undetermined significance, metastatic carcinoma and lymphoma.
Patients having DTC, 70 (44.3%) were diagnosed at stage 1, 17 (10.8%) at stage 2, 12 (7.6%) at stage 3 and 29 (18.3%) have stage 4 disease. 2 (14.3%) patients with medullary carcinoma were diagnosed at stage 1, 4 (28.6%) at stage 3 and 8 (57.1%) were at stage 4. All patients with anaplastic carcinoma had stage 4 disease. Overall cure rate was 33.5%, persistence rate 26.6%, recurrence was 8.2% and thyroid cancer related mortality was 8.9%.
By univariate analysis age, cancer types, distant metastasis, type of surgery and thyroglobulin levels were significant prognostic factors. By multivariate analysis age ≥ 45 years (P=0.04), distant metastasis at the time of presentation (P=0.04), thyroglobulin levels ≥ 8 right after surgery (P≤ 0.001) were found to be independent prognostic factors. Furthermore, other factors like gender and thyroglobulin doubling time did not show any association with the prognosis of thyroid carcinoma.
Conclusion: The current study demonstrated an assessment of prognostic factors in this cohort. Age at diagnosis, distant metastasis and thyroglobulin levels were found to be strong prognostic factors for thyroid carcinoma.
Keywords: thyroid carcinoma, stage, outcome