Endocrine Abstracts

Thyroid cancer is the most common endocrine malignancy. However, some aspects of its management remain controversial. The protocols provided by the British, European and American Thyroid Associations have changed recently and continue to evolve.

We have audited the management of patients with thyroid cancer in a tertiary referral hospital and compared it with the guidelines from the Consensus Statement published by the European Thyroid Cancer Taskforce in 2006.

We retrospectively reviewed the case notes of 98 patients treated with ¹³¹I at our unit between 2003 and 2008.

Median age at diagnosis was 41.5 years. Seventy-six patients had a pre-operative tissue diagnosis. Sixty-five patients had documented neck imaging prior to surgery. All patients were treated with total thyroidectomy. Lymph node dissection was performed in 33 patients, of whom 28 had nodal metastases.

Seventy-three patients had papillary thyroid carcinoma, 17 follicular, one anaplastic, three poorly differentiated and four were diagnosed with tumours of uncertain malignant potential. Based on initial pathology, 57 subjects were classified as high risk for disease recurrence.

All patients received ¹³¹I, 78 patients received 5.55 GBq and 21 received 3.7 GBq. Median time from surgery to radioiodine treatment was 14 weeks.

Seventy-one patients remain under review in our thyroid oncology clinic. Baseline thyroglobulin and TSH have been measured in all patients.

A surveillance programme for assessment of disease status was established in 2006. To date stimulated thyroglobulin has been measured in 46 patients with imaging in 65 patients.

The audit highlights the areas in which we must continue to improve in accordance with the best practice guidelines. Further protocols and additional workforce are required in order to improve the standard of care.