Endocrine Abstracts

Introduction: Thyroid cancer (TC) in adolescents and adults (AYA) is defined as thyroid cancer diagnosed among those aged between 15-39 years. It is the fifth most common cancer in AYAs, and its incidence is increasing. Compared with older adult patients, the AYA with TC has a higher prevalence of node metastasis which represents a risk factor for recurrence.

Aim: To describe the characteristics of thyroid carcinoma with confirmed nodal metastases at the time of diagnosis in an Algerian cohort of AYA patients. And to compare patient with and without lymph nodes metastases.

Methods: Medical records of patients diagnosed with differentiated thyroid carcinoma and aged 18-40 years at the moment of diagnosis followed in the endocrinology department of The University Hospital of Constantine in Algeria during the period between July 2014 and December 2018 were retrospectively reviewed. Clinical and pathological data were collected. The group with no lymph node metastases (LN0) was compared to the group with lymph node metastases (LN1) and factors associated with LN metastases were evaluated.

Results: 101 patients were included, the mean age was 31 (17- 40 years) and 85.1% were females. Total thyroidectomy was done in 88.1% and lymph node dissection in 23.8% which was central in 13.9% and central and lateral in 9.9%. 90.1% of patients had papillary thyroid cancinoma, 7.9% had follicular carcinoma and 2 patients had Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). Following the 8th AJCC classification, 64% were T1, 12.9% T2 and 20.8% were T3. 15.8% had lymph node involvement. Multifocality, bilaterality, vascular thyroid invasion, and capsular thyroid invasion were present in 30.7%, 15.8%, 7.9%, and 17.8%. As for risk stratification according to the ATA system, the initial risk was low, intermediate, and high in 41.6%, 35.6%, and 10.9% of patients, and data were insufficient to state this risk in 11.9% of patients. Thyroid cancer LN1 group had greater tumor size (27.5mm and 17.2mm P= 0.0.38) and thyroid dysfunction (7.1% and 0% P=0.048) at the moment of diagnosis than the LN0 group. There was no difference between thyroid cancer with LN1 and LN1concerning, mean age, sex, pathology type and variant, vascular and capsular invasion.

Conclusion: In this cohort of AYA Algerian patients with thyroid cancer, greater tumor size and thyroid dysfunctions were more important in patients with lymph node metastasis at the moment of diagnosis.