Prognostic factors of differentiated papillary carcinomas: a retrospective analysis on 115patients

Hamza Fatma; Boujelben Khouloud; Hamdi Frikha; Ben Salah; Maalej Souhir; Elleuch Mouna; jardak Issam; Maaloul Mohamed; Mnif Mouna; Mnif Fatma; Charfi Nadia; Hadjkacem Faten; Guermazi Fadhel; Chtourou Khalil; Abid Mohamed; Rekik Nabila

doi:10.1530/endoabs.99.EP1075

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Endocrine Abstracts (2024) 99 EP1075 | DOI: 10.1530/endoabs.99.EP1075

ECE2024 Eposter Presentations Endocrine-Related Cancer (90 abstracts)

Prognostic factors of differentiated papillary carcinomas: a retrospective analysis on 115patients

Hamza Fatma ¹ , Boujelben Khouloud ² , Hamdi Frikha ² , Ben Salah ² , Maalej Souhir ² , Elleuch Mouna ² , jardak Issam ¹ , Maaloul Mohamed ¹ , Mnif Mouna ² , Mnif Fatma ² , Charfi Nadia ² , Hadjkacem Faten ² , Guermazi Fadhel ¹ , Chtourou Khalil ¹ , Abid Mohamed ² & Rekik Nabila ²

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¹Habib Bourguiba University Hospital, Department of Nuclear Medicine; ²Hedi Chaker University Hospital, Department of Endocrinology

Introduction: Differentiated papillary carcinomas (DPC) account for 0.5 to 1% of all neoplasms, and their prognosis is usually favorable. However, a local and distant recurrence is found in up to 35 % of patients. The objective of this study was to determine prognostic factors of this entity among Tunisian population.

Patients and methods: We retrospectively retrieved records of 115 patients diagnosed with DTC and who were then followed at the nuclear medicine department of Habib Bourguiba hospital-Sfax –Tunisia. All patients underwent total thyroidectomy. Radioactive iodine was regularly administrated for intermediate and high risk patients. For each patient, we analyzed age at diagnosis, histological features tumor size nodal status and metastasis. The Cox proportional hazards model was applied to estimate the unadjusted and adjusted hazard ratio (HR) of survival.

Results: On average, 9.5 patients per year was diagnosed with DPC. The mean age was 40 years old (13-83). The mean follow-up was of 13.5 years. Our population was divided into two age groups (≤45 years and >45 years). The Ten year survival was significantly different between the two groups (P=0.03). The 10-year survival rate was 57.1% and 82.1% respectively for men and women (P=0.01). In an adjusted analysis, the risk of death from DPC was significantly correlated with tumor size (P=0.006). Tumor necrosis and multifocality were demonstrated as poor prognostic factors (P=0.013 and 0.038 respectively). The 10-year survival rate was 93.2% for patients with pN0 versus 58,1 % for those with pN1. Then, lymph node metastasis was also identified as a strong prognostic factor in patients with DPC (p < 0.001). Nevertheless, the presence of metastasis at the time of diagnosis showed no significant impact on survival (P=0.431).

Conclusion: Although DPC is commonly considered as a low-risk tumor, our study identified several factors influencing the prognosis of DPC. Early aggressive should be instituted for patients presenting those factors in order to improve survival and life quality.