Background: The incidence of thyroid cancer in South Korea has increased rapidly. Increase in medical surveillance and access to health care services have enhanced the detection of asymptomatic tumors. We investigated the differences of tumor characteristics between South Korean patients and Northern Italian patients subject to different healthcare systems.
Methods: The demographic, histopathologic and management features of thyroid cancer operated in two tertiary referral hospitals in Seoul, South Korea (n=4,474) and Varese, Northern Italy (n=2,897) from years 2000 to 2015 were analyzed.
Results: The mean age of diagnosis was similar (49 years) among the Korean and Italian patients. However, the proportion of female was higher among Korean patients (81.3 vs 74.2%, P<0.001). The proportion of papillary subtype was higher (99.2 vs 92.6%, P<0.001) and the size of tumor was smaller (1.03±0.83 vs 1.79±1.01 cm, P<0.001) in the Korean subjects. Interestingly, the prevalence of multifocality (37.8 vs 8.2%), extrathyroidal extension (41.6 vs 13.1%) and lymph node metastasis (34.8 vs 6.7%) was also higher in the Korean patients (P<0.001). Most of the Italian cases received total thyroidectomy (96.0%). In comparison, a considerable number of the Koreans (21.9%) received hemithyroidectomy as initial surgical treatment (P<0.001). The proportion of the patients who received radioactive iodine therapy was significantly higher among the Korean patients (53.3 vs 29.7%, P<0.001).
Conclusion: We have identified distinct lineaments of thyroid gland cancer between the two different nationalities which could not be explained entirely by early detection from screening. Further prospective studies with controlled treatment strategies are needed to determine long-term prognosis.
20 - 23 May 2017
European Society of Endocrinology