Endocrine Abstracts

The incidence of thyroid cancer (TC) is increasing over time. Follow up and adequate treatment of patients with TC is important in everyday routine practice. The aim of the study was to evaluate peculiarities of clinical and pathologic characteristics of patients with TC, and their management after surgery.

Material and methods: We conducted retrospective review of medical records of 116 patients with TC after thyroid surgery followed up in Vilnius Antakalnio out–patient clinic. We recorded demographic, clinical characteristics, TC morphology and extension, treatment and TSH changes.

Results: Mean patients’ age was 57.24±16.45 years (87.1% female). Mean age at surgery was 49.04±15.56 years. 44.9% patients were 41–60 years old at the time of surgery. 88.8% of patients had multinodular goitre. 107 patients had papillary TC, 5 medullary, 4 other type. 22.9% patients had capsular invasion, 14.0% – vascular invasion, 19.2% – lymph node metastases. Patients with TC with vascular invasion were older than patients with TC without vascular invasion (37.62±15.08 vs 49.30±15.00, P=0.011). 67.3% patients were diagnosed at stage 1, 9.6% at stage 2, 19.2% at stage 3 and 3.8% had stage 4 disease. Mean TSH before surgery was 2.01±1.87 mUI/l. Neither the presence of extra thyroidal extension, nor vascular invasion, nor cancer stage was associated with TSH levels. Total thyroidectomy was performed in 90.5% of patients and hemithyroidectomy in 9.5%. Radioiodine was administered to 94 patients. Patients have been followed up for 6.50±5.74 year (range 0–26). Mean daily dose of L-thyroxin was 133.81±35.59 mcg (1.85±0.56 mcg/kg) keeping TSH suppression at the level of 0.43±0.65 mUI/l (range 0-3.63). L-thyroxin dose correlated with patient’s weight (P<0.0001).

Conclusions: Most frequently thyroid cancer is diagnosed in 41–60 years’ women and presents as multinodular goitre, and papillary carcinoma. Long-term TSH suppression after thyroid cancer surgery is kept in conformity with recommendations.