Journal of Clinical Oncology, 2004 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 22, No 14S (July 15 Supplement), 2004: 5615
© 2004 American Society of Clinical Oncology

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Abstract

Outcome of well differentiated thyroid cancer: Single institution results

Hacettepe University Institute of Oncology, Ankara, Turkey; Hacettepe University Nuclear Medicine, Ankara, Turkey

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Background: The primary goal of this study is to present the single institution experience with emphasis on clinical, pathological and therapeutic measures on the outcome of differentiated thyroid cancer (DTC). Methods: Cases of DTC were retrospectively analyzed for the period of 1986 to 2003 the Medical Oncology Department of the Hacettepe Medical Faculty. Results: A total of 118 patients with papillary (PC) and follicular thyroid cancer (FC) were included in this retrospective study. The median age was 37 years in PC and 49 years in the FC patients. Histologically; 93 (68 female and 25 male) (78.8%) patients have PC and 25 (20 female, 5 male) (21.2%) FC. Nearly half had a near total or total thyroidectomy and other half lobectomy or a partial thyroidectomy. Fifty-four (%45.8) patients underwent to additional surgery due to insufficient primary surgery. There was no disease free survival (DFS) difference between these groups. There was no difference in DFS among males and females, in the subgroups of <45 and >45 year age groups and PC and FC subtypes. The median tumor size was 1.8 cm for papillary, 2.2 cm for follicular and 2.0 cm in overall. The tumor size 2 cm associated with worse DFS (p = 0.028). Extrathyroidal extension, multicentricity, vascular invasion, lymph node involvement of tumor did not affect the DFS. Eight patients developed distant metastasis; most frequent sites were lung and bone. The median period of time to develop metastasis was 50.0 months (16–95 months). Ninety-eight (83.1%) patients received ablative I-131 with the median dose of 132.5 mCi and 20 (16.9%) patients did not. Twenty-nine patients (24.6%) required additional treatments, which the median dose was 150 mCi. There was no difference in DFS between the patients treated with and without I-131 therapy. Two patients died from disease till the time of analysis. Median follow up period is 57.0 months (1 to 200). DFS rate for five years was 93.2%. Over all survival rate for five years was 98.3%. Conclusions: In our study, tumor size is the only prognostic factor for DFS. The extent of surgery and dose of I 131 therapy, in this study did not affect long term disease free survival. I 131 therapy may be beneficial in selected patients only.

No significant financial relationships to disclose.