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I‐131 AND SURVIVAL IN DIFFERENTIATED THYROID CANCER
Author(s) -
Allison R.
Publication year - 2009
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.1445-2197.2009.04916_26.x
Subject(s) - medicine , thyroid cancer , stage (stratigraphy) , cohort , cancer , cancer registry , thyroid , incidence (geometry) , disease , oncology , gynecology , paleontology , physics , optics , biology
Data from the Queensland Cancer Registry and our Multidisciplinary Thyroid Cancer Clinic indicate that thyroid cancer incidence is increasing. This is particularly in well differentiated tumours in women. Whilst some of the increase may be due to ascertainment, there appears to be a genuine increase. The cause for this is unknown. Surgery for the primary and nodal disease remains the mainstay of treatment. Adjuvant treatment with I‐131 for ablation of remnants and treatment of unresectable disease is the next echelon of treatment. From 1980 to 2007 the Thyroid Cancer Clinic at the Royal Brisbane and Women's Hospital saw 3061 patients. The overall 15 year disease specific survival is 86%. However, if we look at the well differentiated cohort of papillary follicular and Hurthle cell tumours, the 15 year disease specific survival rises to 90%. This is based on 2377 patients. Significant survival variables are sex (Females – 93%, males – 79% – 15 year survival), age (0–44 – 98%, 45–59 – 94%, 60–69 – 70%, 70+ 36%), for T stage only T4 is significant, for M stage M0 is 91% and M1 is 62%, nodal status shows a non‐significant trend N 0 – 93%, N positive – 84%.Our practice, in line with international guidelines, is to offer adjuvant treatment with I‐131 for tumours above 15?mm, to consider treatment on risk factors between 10–15?mm and not to treat tumours under 10?mm. Despite these good results, patients would benefit from a better ability to define a good prognosis group in whom we could avoid treatment and also identify the worst prognosis group in whom to escalate treatment.