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SURGICAL MANAGEMENT OF WELL‐DIFFERENTIATED THYROID CANCERS; RISK GROUP STRATIFICATION AND PREDICTORS OF OUTCOME
Author(s) -
Sarinah B.,
Hisham A. N.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04118_10.x
Subject(s) - medicine , thyroid cancer , disease , risk stratification , surgery , metastasis , stage (stratigraphy) , thyroid , oncology , cancer , paleontology , biology
Objective The aim of this study was to evaluate the predictive ability of outcomes in the management of well‐differentiated thyroid cancers (WDTC). Method & Materials A total of 115 patients operated for primary WDTC from 2002 to 2006 were included in this study. The patient’s demographic data, clinical manifestation, tumour characteristics and outcomes were reviewed. Risk group stratifications were applied using pTNM, AMES and MACIS prognostic systems. Results There were 81(70%) women and 34(30%) men with the median age of 44 years (ranged 6 to 78 years). Our results showed that at the median follow up period of 19 months, 93(80.1%) patients are still alive without recurrence disease, 5(4.3%) patients succumbed to the disease and 3(2.6%) are still alive with persisting disease. Local and nodal recurrence occurred in 14(12.2%) patients after primary surgery, of which 12(10.4%) patients already had nodal metastasis at presentation. All 5 patients who succumbed to the disease were proven to be advanced stage with nodal metastasis, coupled with incomplete surgical resection. In addition 3(2.6%) of them also had distant metastasis at presentation. All patients who died were in the high‐risk groups of AMES scoring system, either staged 3 or 4 of pTNM classification and/or scored more than 8 in MACIS prognostic scoring. Conclusions Our study emphasized the important of risk group stratification, which may indicate the need for a more aggressive surgical treatment. Poorer survival and outcome is expected if WDTC are locally advanced with nodal and distant metastasis coupled with inability to achieve complete resection.