Analysis of pattern of occurrence of thyroid carcinoma between 2001 and 2010

Girardi, Fábio Muradás; Barra, Marinez Bizarro; Zettler, Cláudio Galleano

doi:10.1016/j.bjorl.2015.07.015

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Brazilian Journal of Otorhinolaryngology

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ORIGINAL ARTICLES • Braz. j. otorhinolaryngol. 81 (5) • Sep-Oct 2015 • https://doi.org/10.1016/j.bjorl.2015.07.015 copy

Analysis of pattern of occurrence of thyroid carcinoma between 2001 and 2010^☆ ☆ Please cite this article as: Girardi FM, Barra MB, Zettler CG. Analysis of pattern of occurrence of thyroid carcinoma between 2001 and 2010. Braz J Otorhinolaryngol. 2015;81:541-8. ^☆☆ ☆☆ Institution: Santa Rita Hospital - Hospital Complex, Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

INTRODUCTION:

An ongoing discussion is found in medical literature about the reasons for changes in thyroid carcinoma incidence patterns over the last decades.

OBJECTIVE:

To analyze the clinical and pathological characteristics of thyroid carcinoma cases over a decade.

METHODS:

Cross-sectional study over an historical cohort. Medical records of 628 thyroid cancer cases in a single center were reviewed. 597 patients were included. Microcarcinoma cases were selected for a qualitative analysis phase, in which medical records were reviewed for better understanding of thyroid nodule and thyroid cancer diagnosis process.

RESULTS:

An increase in the proportion of cases with thyroid cancer diagnosis was observed throughout the decade; new cases were predominantly tumors of less than 2 cm, with histopathological signs of low aggressiveness. There was an increase in proportion of cases with malignant cytological results among microcarcinomas.

CONCLUSION:

There is a trend for increase in thyroidectomies due to cancer in this institution, with proportional increment of cases with histopathological characteristics indicative of early disease. Among microcarcinomas, there is an increasing group represented by cancer cases that were not incidentally diagnosed, related to an enhancement in preoperative diagnostic methods.

Keywords:
Papillary carcinoma; Incidence; Epidemiology; Thyroid neoplasms; Thyroid nodule

	2001–2005	2006–2010	Total	p-Value
	Mean ± SD	Mean ± SD	Mean ± SD
Age	47.93 ± 16.03	48.20 ± 14.48	48.11 ± 14.97	0.8452
Tumor diameter	2.43 ± 2.22	1.89 ± 1.86	2.06 ± 1.99	–

	2001–2005	2006–2010	Total	p-Value
	Median (Min–Max)	Median (Min–Max)	Median (Min–Max)
Tumor diameter	1.7 (0.04–10)	1.2 (0.1–15)	1.3 (0.04–15)	0.0412

	2001–2005		2006–2010		Total		p-Value
	n	%	n	%	n	%
Thyroidectomies	1403	39.6	2133	60.3	3536	100	0.0002
Thyroidectomies due to cancer	189	13.4	408	19.1	597	16.8	0.0002

Gender							0.1752
Male	45	23.8	76	18.6	121	20.2
Female	144	76.1	332	81.3	476	79.7

Age (categories)							0.8806
<45 years	77	40.7	162	39.7	239	40.0
>45 years	112	59.2	246	60.2	358	59.9
HN Surgical Team	116	61.3	323	79.1	439	73.5	0.0001
MBB, Pathologist	173	91.5	384	94.1	557	93.2	0.3181

Histology (CA)							0.1875
Papillary	160	84.6	366	89.7	526	88.1
Follicular	13	6.8	19	4.6	32	5.3
Medullary	10	5.2	9	2.2	19	3.1
PD	1	0.5	5	1.2	6	1.0
Anaplastic	5	2.6	9	2.2	14	2.3

Hashimoto's thyroiditis ^a	43	22.7	116	28.4	159	26.6	0.1736
Follicular lesions ^a	50	26.4	136	33.3	186	31.1	0.1112
Lymphovascular or neural invasion	25	13.2	51	12.5	76	12.7	0.9076
Multifocality	51	26.9	151	37.0	202	33.8	0.0206

Diameter (categories)							0.0354
≤1.0	61	32.2	163	39.9	224	37.5
1.1–2.0	49	25.9	121	29.6	170	28.4
2.1–3.0	22	11.6	44	10.7	66	11.0
3.1–4.0	17	8.9	31	7.5	48	8.0
>4.0	40	21.1	49	12.0	89	14.9

Invasion of glandular capsule	123	65.0	210	51.4	333	55.7	0.0025
Extraglandular commitment	73	38.6	118	28.9	191	31.9	0.0232
Positive cervical LNs	49	25.9	92	22.5	141	23.6	0.4237
LNs committed in lateral compartment	18	9.5	38	9.3	56	9.3	0.9347

Stage							0.0509
I–II	124	65.6	301	73.7	425	71.1
III–IV	65	34.3	107	26.2	172	28.8

	2001–2005		2006–2010		Total
	n	%	n	%
A-1	6	42.8	5	33.3	11
A-1.1	1	16.6	1	20.0	2
A-1.2	0	0	2	40.0	2
A-1.3	3	50.0	2	40.0	5
A-1.4	2	33.3	0	0	2
A-2	8	57.1	10	66.6	18
B-1	6	21.4	46	38.9	52
B-1.1	5	83.3	40	86.9	45
B-1.2	1	16.6	3	6.5	4
B-1.3	0	0	3	6.5	3
B-2	6	21.4	22	18.6	28
B-2.1	2	33.3	3	13.6	5
B-2.2	3	50.0	16	72.7	19
B-2.3	1	16.6	3	13.6	4
B-3	16	57.1	50	42.3	66
B-3.1	5	31.2	10	20.0	15
B-3.2	7	43.7	22	44.0	29
B-3.3	4	25.0	18	36.0	22

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
E-mail: revista@aborlccf.org.br

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[1] * Corresponding author. E-mail:fabiomgirardi@gmail.com (F.M. Girardi).