Kalmovich, Limor Muallem1,3; Steinshneider, Miriam2,3; Koren, Shlomit2,3; Or, Karen2; Kummer, Esther2, Benbassat, Carlos2,3.
1 Department of ENT, Assaf Harofeh Medical Center, Zerifin, Israel
2 Endocrine Institute, Assaf Harofeh Medical Center, Zerifin, Israel
3 Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Background: New ATA guidelines for management of thyroid nodules remain controversial. Hospital-based registries can be a very helpful tool. We sought to stablish a database for all thyroid cancer patients treated at our institution.
Methods: a computer search using “thyroid neoplasm” as keyword was conducted for all hospital records during 1990-2015. Data on demographics, risk factors, medical history, diagnostic workup, primary treatment, follow-up and outcome were obtained and plotted in an excel spreadsheet.
Results: We retrospectively registered 441 non-medullary thyroid cancer patients treated during 1962-2015 (414 during 1990-2015), of whom 80% were operated. mean age 47.7 y, female 75.5%, familial 10.5%, radiation exposure 7.2%, PTC 89.1%, FTC 6.7%, others 4.2%. Disease extension at diagnosis was: microcarcinoma 33%, multifocality 38.3%, extrathyroidal 20%, lymph node metastases 27.4%, distant metastases (DM) 4.7%, TNM stage III-IV 25.7%. Near total thyroidectomy was performed in 86.6% and neck dissection in 25.7% patients. RAI was given to 86.5% patients, with a mean first dose of 110 mCi. Additional follow up treatment included reoperation in 8.5%, repeated RAI in 34.8%, for a median cumulative dose of 130 mCi. New DM were diagnosed in 5.8% patients. Persistent disease was recorded in 25% and 16% patients at 1 year and last visit, respectively. At a mean follow up of 9.7±8.8 y, overall mortality was 10.4% and disease related mortality 3.1%.
Conclusions: This Israeli second-largest hospital-based thyroid cancer registry will add to bigger sample population in future clinical studies aiming to improve thyroid cancer patients care.