Endocrine Abstracts

Well-differentiated thyroid carcinoma (WDTC) is the most common thyroid malignancy. Although, associated with good prognosis, it may have a highly recurrent and fatal outcome in selected groups of patients. Filipinos in particular were reported to be the ethnic group with the highest incidence of thyroid cancer in several studies. Thyroid cancer among Filipinos were also observed to be more aggressive and recurrent in nature. This paper aims to describe the experience of a Philippine Tertiary Care Centre in managing patients with differentiated thyroid cancer. This is a retrospective cohort study of 723 patients diagnosed with WDTC (649 papillary and 79 follicular). We evaluated clinic–pathologic profile, ultrasound features, management received, clinical course, tumour recurrence, and eventual outcome during a mean follow-up period of 5 years. Mean age at presentation was 43±13 for papillary thyroid cancer (PTC) and 44±13 for follicular thyroid cancer (FTC). Majority of both PTC (63.2%) and FTC (54.4%) presented initially as stage 1. Greater FTC cases (12.7% vs 3.7%) presented with distant metastases with lung and bone being the most common. Nodal metastases at presentation were frequent among PTC (29.9% vs 7.6%). Majority of cases received complete thyroidectomy, subsequent radioactive iodine therapy and TSH suppression therapy which led to disease free state. Excluding patients with distant metastases at presentation, recurrence rates for papillary and follicular thyroid cancer were 30.1 and 18.8% respectively. Recurrences for PTC and FTC frequently occurred within 15–16 months from the initial post-surgical radioactive iodine therapy. PTC among Filipinos presents at a younger age, larger tumour size, higher distant metastases at presentation and a higher recurrence rate suggesting a more aggressive and recurrent behaviour for this type of thyroid malignancy. FTC among Filipinos also presents at a younger age and a higher recurrence rate but appears to behave similarly with other racial groups.