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Thyroid carcinoma--problems in management.

E H Ng1, R Nambiar

  • 1Department of Surgery, Singapore General Hospital.

Annals of the Academy of Medicine, Singapore
|January 1, 1988
PubMed
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This study on thyroid carcinoma found an increasing incidence with age. Diagnostic limitations led to staged surgeries, with age, local invasiveness, and metastases impacting survival.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Pathology

Background:

  • Thyroid carcinoma presents diagnostic challenges.
  • Surgical management requires careful consideration of staging and patient factors.
  • Long-term outcomes are influenced by specific prognostic indicators.

Purpose of the Study:

  • To review surgically treated thyroid carcinoma cases over a decade.
  • To analyze trends in incidence and diagnostic accuracy.
  • To identify significant prognostic factors for patient survival.

Main Methods:

  • Retrospective review of 71 surgically treated thyroid carcinoma cases (1976-1985).
  • Analysis of clinical data, diagnostic modalities (thyroid scans, ultrasonography, frozen section), and surgical outcomes.

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  • Evaluation of prognostic factors including age, local invasiveness, and distant metastases.

    • Main Results:

    • A rising incidence of thyroid carcinomas, particularly papillary carcinomas, was observed with increasing age.
    • Preoperative and operative diagnosis of malignancy was limited, with only 27% confirmed histologically.
    • 35% of patients required staged procedures for total thyroidectomy due to diagnostic limitations.
    • Age at diagnosis, local invasiveness, and distant metastases were significant prognostic factors for survival.

    Conclusions:

    • Diagnostic modalities for thyroid carcinoma during the study period were limited, impacting surgical planning.
    • Age, local invasiveness, and the presence of distant metastases are critical prognostic factors in thyroid carcinoma.
    • Further improvements in diagnostic accuracy are crucial for optimizing surgical treatment and patient outcomes.