OUTCOMES OF DIFFERENTIATED THYROID CARCINOMA (DTC) PATIENTS AT MAHARAJ NAKORN CHIANG MAI HOSPITAL (MNCM)

Supawan Buranapin; Laddawan Limpijarnkit; Natapong Kosachunhanun; Jongkol Vachiranakorn; Ampica Mangklabruks

OUTCOMES OF DIFFERENTIATED THYROID CARCINOMA (DTC) PATIENTS AT MAHARAJ NAKORN CHIANG MAI HOSPITAL (MNCM)

Date

2007-11-30

Authors

Supawan Buranapin

Laddawan Limpijarnkit

Natapong Kosachunhanun

Jongkol Vachiranakorn

Ampica Mangklabruks

Publisher

Chiang Mai Medical Journal

Abstract

Objective: To compare the outcome of DTC patients treated at MNCM with various types of therapy. End point measurements were cancer recurrence and cancer death. Materials and methods: A retrospective review of all available medical records of DTC patients from January 1988 to December 1998 was performed. Some patients, who were diagnosed DTC long before 1988 and had continued to follow-up, were included in this study. There were 292 patients (225 female and 67 male) comprising 54.5% papillary cell carcinoma, 39.7% follicular cell carcinoma and 5.8% mixed papillary and follicular cell carcinoma. Results: The mean age at diagnosis was 43.6±0.86 years. The female to male ratio was 3:1 and mean tumor size 3.8 cm. The outcomes among 4 types of therapy were compared: surgery alone, surgery combined with thyroid hormone suppression (THS), surgery combined with THS and I131 remnant ablation started within 1 year after surgery, and surgery combined with THS and I131 remnant ablation started more than 1 year after surgery. There were no significant differences among the groups of therapy regarding sex, tumor size, cell type, local tumor invasion and cervical node metastasis, but age at diagnosis and distant metastasis were significantly different. The mean survival time for each treatment group was 8.04, 10.67, 23.97 and 12.11 years, respectively (p=0.03). Disease free interval in each treatment groups was 6.72, 8.72, 19.94 and 9.53 years, respectively, (p=0.003). Factors that influenced cancer death were cervical node metastasis, distant metastasis and thyroid remnant ablation. Factors that influenced cancer recurrence were age at diagnosis, cervical node metastasis, distant metastasis and thyroid remnant ablation. Conclusion: This study suggested that thyroid remnant ablation is effective in decreasing cancer recurrence and cancer death in DTC patients.

Citation

Chiang Mai Medical Journal; Vol.46 No.3 September 2007 (pages 93 - 127); 93 - 100

URI

https://imsear.searo.who.int/handle/123456789/130640

Collections

Chiang Mai Medical Journal

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