Paola Solis-Pazmino1,2,3, Jorge Salazar-Vega3,4,5, Eddy Lincango-Naranjo2,3,6, Cristhian Garcia3,7, Gabriela Jaramillo Koupermann3,8, Esteban Ortiz-Prado9, Tannya Ledesma3,6, Tatiana Rojas3,10, Benjamin Alvarado-Mafla3, Cesar Carcamo11, Oscar J Ponce2,3,12, Juan P Brito2,3,13. 1. Otolaryngology Head and Neck Department, Stanford University, Palo Alto, California, USA. 2. Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA. 3. CaTaLiNa (Thyroid Cancer in LatinAmerica), Quito, Ecuador. 4. Endocrinology Department, Hospital de Especialidades Eugenio Espejo, Quito, Ecuador. 5. One Health Research Group, Universidad de las Americas, Quito, Ecuador, 170137, Quito, Ecuador. 6. Universidad Central del Ecuador, Medical School, Quito, Ecuador. 7. Surgery Department, Hospital de Especialidades Eugenio Espejo, Quito, Ecuador. 8. Molecular Biology Department, Hospital de Especialidades Eugenio Espejo, Quito, Ecuador. 9. One Health Research Group, Universidad de las Americas, Quito, Ecuador, 170137, Quito, Ecuador. e.ortizprado@gmail.com. 10. Universidad San Francisco de Quito, Quito, Ecuador. 11. School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru. 12. Unidad de Conocimiento y Evidencia, Universidad Peruana Cayetano Heredia, Lima, Peru. 13. Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA.
Abstract
BACKGROUND: In contrast to the rapid increase in thyroid cancer incidence, the mortality has remained low and stable over the last decades. In Ecuador, however, thyroid cancer mortality has increased. The objective of this study is to determine possible drivers of high rates of thyroid cancer mortality, through a cross-sectional analysis of all patients attending a thyroid cancer referral center in Ecuador. METHODS: From June 2014 to December 2017, a cross-sectional study was conducted at the Hospital de Especialidades Eugenio Espejo, a regional reference public hospital for endocrine neoplasia in adults in Quito, Ecuador. We identified the mechanism of detection, histopathology and treatment modalities from a patient interview and review of clinical records. RESULTS: Among 452 patients, 74.8% were young adults and 94.2% (426) were female. 13.7% had a family history of thyroid cancer, and patients' median tumor size was 2 cm. The incidental finding was 54.2% whereas 45.8% was non-incidental. Thyroid cancer histology reported that 93.3% had papillary thyroid cancer (PTC), 2.7% follicular, 1.5% Hurtle cells, 1.6% medullary, 0.7% poor differentiated, and 0.2% anaplastic carcinoma. The mean MACIS (metastasis, age, completeness, invasion, and size) score was 4.95 (CI 4.15-5.95) with 76.2% of the thyroid cancer patients having MACIS score less than or equal to 6. The very low and low risk of recurrence was 18.1% (79) and 62% (271) respectively. An analysis of 319 patients with non-metastatic thyroid cancer showed that 10.7% (34) of patients had surgical complications. Moreover, around 62.5% (80 from 128 patients with thyroglobulin laboratory results) of TC patients had a stimulated-thyroglobulin value equal or higher than 2 ng/ml. Overall, a poor surgical outcome was present in 35.1% (112) patients. Out of 436 patients with differentiated thyroid carcinoma, 86% (375) received radioactive iodine. CONCLUSION: Thyroid cancer histological characteristics and method of diagnosis are like those described in other reports without any evidence of the high frequency of aggressive thyroid cancer histology. However, we observed evidence of overtreatment and poor surgical outcomes that demand additional studies to understand their association with thyroid cancer mortality in Ecuador.
BACKGROUND: In contrast to the rapid increase in thyroid cancer incidence, the mortality has remained low and stable over the last decades. In Ecuador, however, thyroid cancer mortality has increased. The objective of this study is to determine possible drivers of high rates of thyroid cancer mortality, through a cross-sectional analysis of all patients attending a thyroid cancer referral center in Ecuador. METHODS: From June 2014 to December 2017, a cross-sectional study was conducted at the Hospital de Especialidades Eugenio Espejo, a regional reference public hospital for endocrine neoplasia in adults in Quito, Ecuador. We identified the mechanism of detection, histopathology and treatment modalities from a patient interview and review of clinical records. RESULTS: Among 452 patients, 74.8% were young adults and 94.2% (426) were female. 13.7% had a family history of thyroid cancer, and patients' median tumor size was 2 cm. The incidental finding was 54.2% whereas 45.8% was non-incidental. Thyroid cancer histology reported that 93.3% had papillary thyroid cancer (PTC), 2.7% follicular, 1.5% Hurtle cells, 1.6% medullary, 0.7% poor differentiated, and 0.2% anaplastic carcinoma. The mean MACIS (metastasis, age, completeness, invasion, and size) score was 4.95 (CI 4.15-5.95) with 76.2% of the thyroid cancerpatients having MACIS score less than or equal to 6. The very low and low risk of recurrence was 18.1% (79) and 62% (271) respectively. An analysis of 319 patients with non-metastatic thyroid cancer showed that 10.7% (34) of patients had surgical complications. Moreover, around 62.5% (80 from 128 patients with thyroglobulin laboratory results) of TCpatients had a stimulated-thyroglobulin value equal or higher than 2 ng/ml. Overall, a poor surgical outcome was present in 35.1% (112) patients. Out of 436 patients with differentiated thyroid carcinoma, 86% (375) received radioactive iodine. CONCLUSION:Thyroid cancer histological characteristics and method of diagnosis are like those described in other reports without any evidence of the high frequency of aggressive thyroid cancer histology. However, we observed evidence of overtreatment and poor surgical outcomes that demand additional studies to understand their association with thyroid cancer mortality in Ecuador.
Entities:
Keywords:
Ecuador; Histopathology; Latin-America; Outcome; Surgical; Thyroid Cancer
Authors: Young Woo Chang; Hwan Soo Kim; Seung Pil Jung; Hoon Yub Kim; Jae Bok Lee; Jeoung Won Bae; Gil Soo Son Journal: Int J Clin Oncol Date: 2016-02-02 Impact factor: 3.402
Authors: María Fabiana Russo Picasso; Jimena Vicens; Carina Giuliani; Ana Del Valle Jaén; Carmen Cabezón; Marcelo Figari; Ana María Gómez Saldaño; Silvana Figar Journal: J Cancer Epidemiol Date: 2018-07-15