Cáncer de tiroides: análisis de los procedimientos diagnósticos, tratamiento y control de una serie de 151 casos / Thyroid cancer: analysis of the diagnosis, treatment and follow up in 151 cases

ABSTRACT

Background: There is debate about the use of total thyroidectomy or conservative surgery, and radioiodine or external radiotherapy for differentiated thyroid carcinoma. Aim: To report our experience in the management of thyroid carcinoma. Patients and methods: A retrospective review of 151 patients with thyroid carcinoma (TC) and 343 patients with benign nodules (BN) subjected to thyroidectomy by the author. All TC patients received radioiodine therapy and those with extrathyroidal involvement were subjected to external radiotherapy. Results: Patients with thyroid carcinoma and benign nodules had similar sex distribution, ages of presentation and evolution times. Nodules of less than 3 cm were found in 31 and 19 percent of patients with CT and BN respectively. Cold nodules on scintigraphy were found in 89 and 75 percent of patients with TC and BN respectively. Solid nodules on ultrasound examination were found in 93 and 76 percent of patients with TC and BN respectively. Fine needle aspiration cytology had a 78 percent sensitivity and 65 percent specificity for the diagnosis of TC. Forty percent of patients with TC and 9 percent of patients with BN were subjected to total thyroidectomy. In 3 percent of patients, the recurrent nerve was damaged and in 0.6 percent hypoparathyroidism was caused. Pathological examination showed that 137 carcinomas were differentiated, 6 were medullary and 8 were indifferentiated. There were 10 deaths (6.6 percent) in the two years of follow up of patients with TC. Conclusions: This series confirms the efficacy of surgical and radiotherapeutic procedures for thyroid cancer