Endocrine Abstracts

Introduction: Today, thyroid papillary cancer remains to be the most frequent diagnosed malignancy. Despite highly positive outcomes, treatment protocol still requires surgical intervention, which, in turn often affects not only thyroid and regional lymph nodes, but also recurrent nerve and parathyroid glands. The aim of our study was to compare the metabolic compensation of calcium and thyroid metabolism improvement in patients operated on thyroid cancer recently and 20 years ago.

Material and Methods: We have examined two groups of patients (in total 104 men and women with the age of 21 to 43 years old at the moment of operation) treated on highly differentiated thyroid carcinoma in different time periods (1998–2000 and 2018–2029). The first one, analyzed retrospectively, consisted of 44 patients aged 22.16 ± 7.51at the moment of operation, the second one recently selected included 60 patients with mean age 22.16 ± 7.5 years. Both groups did not differ significantly by the age at the moment of operation, as well as by staging – all were marked as stage 2 by pTNM. Daily prescribed amount of levothyroxin was recorded. Tests for TSH, FT4, TG, Parathormone were made using ELISA-DRG (USA) kits and serum calcium levels were estimated on Cormay-Diana biochemical analyzer (Poland).

Results: As a result, comparing two groups we have seen no significant difference in FT4 levels, though significant decrease in mean TSH levels was observed in between groups (0.6420 ± 0.74 mUI/l in group 1 vs 0.3275 ± 0.62 mUI/l) (P < 0.05) on the almost similar amounts of thyroxin intake 160.14 ± 28.89 vs 153.95 ± 31.21 mg/day respectively, showing significant improvement in compliance and target TSH suppression levels achievement over time. As for the calcium levels – they have also significantly improved over the time of surgical experience – 1.97 ± 0.17 in group 1 vs 2.37 ± 0.12 in group 2 (P < 0.05) – two decades later. Alongside with the positive shifts – a worrying difference in TG levels was determined –1.91 ± 3.30 ng/ml vs 2.49 ± 3.96 ng/ml (P = 0.03) That can be explained either by different reagent sensitivity or higher relapse tendency in more sparing surgical techniques.

Conclusion: Improvement of surgical techniques and reduction of postoperative hypoparathyroidism is obvious, but still the minimally invasive approach requires more clinical observation and follow up.