Papillary Thyroid Carcinoma: The Clinical Experience at the Endocrinology Section of the University District Hospital of Puerto Rico

Program: Abstracts - Orals, Poster Previews, and Posters
Session: SAT 270-310-Thyroid Neoplasia (posters)
Saturday, April 2, 2016: 1:15 PM-3:15 PM
Exhibit/Poster Hall (BCEC)

Poster Board SAT 291
Anette Garces-Dominguez*1, Loida Alejandra Gonzalez-Rodriguez1, Gustavo Armaiz-Peña2, Eduardo Santiago-Rodriguez3, Dalitza Marie Alvarez-Valentin1, Viviana M. Ortiz-Santiago1 and Marielba Agosto-Mujica1
1Puerto Rico University Hospital, Medical Sciences Campus (MSC), PR, 2University of Puerto Rico, Medical Sciences Campus, PR, 3Puerto Rico Clinical and Translational Research Consortium, PR
Introduction: Differentiated thyroid cancer refers to both papillary and follicular classifications. Papillary Thyroid Carcinoma (PTC) represents 85–90% of all thyroid carcinomas. Incidence rates differ by race and ethnicity. Rates are twice as high among Whites vs Blacks, notably elevated among Asians. There are few studies describing the incidence, rates and prognosis of PTC in Hispanic populations specifically in Puerto Rico. It is of clinical importance to study and understand this disease in our population for improvement in diagnostic methods, directed therapy, long term follow up and risk stratification. The aim of our study was to determine the clinico-pathological characteristics of PTC in patients treated at our institution in a 10-year period, and to identify factors affecting prognosis and recurrence of the disease.

Methods: A retrospective chart review of patients evaluated at the General Endocrinology Clinics of the University District Hospital in San Juan, Puerto Rico from July 1st2003 to June 30, 2013 was performed. Parameters extracted included: sociodemographic information, medical history, age and symptoms at diagnosis, mode of diagnosis, location of tumor, presence of metastases, treatment given for cancer, remission history and follow up data. Data was described using median (range) on continuous variables and frequencies and proportions on categorical variables. Differences between categorical variables were evaluated with chi-square or Fisher’s exact tests, and significance was set at 0.05.   

Results: A total of 137 patients with PTC were included in this study, with a median (range) age at diagnosis of 44.5 (7-77) years. The majority of patients were females (86.1%). Only 19.5% of patients had thyroid dysfunction at the moment of diagnosis. Among major risk factors for the development of PTC in our population we found that 2.2% were current smokers and 8.8% had family history of thyroid cancer. Sixty four percent of cases were diagnosed by FNAB whereas 36% were found incidentally after thyroidectomy. The most common preoperative sonographic characteristic was hypoechoic nodule (34.7%). Forty three percent of patients had multifocal PTC on surgical specimen, with 18.3% presenting capsular invasion. Total thyroidectomy was the surgical approach of choice in our population. Only 22 cases had metastatic disease, mostly locoregional (72.7%). The majority of our patients received radioiodine ablation therapy (82.5%). Bigger tumors were more likely to present capsular invasion and metastases (p<0.05). The prevalence of recurrent/persistent disease was 22.6%.

Conclusion: The clinical course of Papillary Thyroid Carcinoma in our Hispanic population resembles other ethnic groups. The prevalence of recurrent/persistent disease in our study was similar to the data found in other populations.

Nothing to Disclose: AG, LAG, GA, ES, DMA, VMO, MA

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