Nodule and cancer assessment following thyroid surgery: a cohort of 460 patients

Thyroid nodule formation and the cancer risk of these nodules have recently become widely researched topics. Developments in diagnosis and treatment options have correlated with an increased number of diagnosed patients. However, such a high number of malignant patients in a single center is rare, and this advantage is able to assess the patients in reverse by reviewing nodularity in the malignant patient population. In this study, we retrospectively reviewed nodularity and malignancy following thyroid surgery in a high-risk population with high thyroid cancer rates.

Out of 1,007 thyroid patients either referred to or operated on at Ankara Oncology Training and Research Hospital between January 1995 and December 2003, 460 patients with readily available data were included in the study.

Of the 460 patients, 74.9% were female and 25.1% were male. The mean age of female patients operated on due to thyroid nodules was 43.7 years (SD: 14.7; range: 12-81) and 47.1 years for males (SD: 14.6; range: 14-80) (p = 0.02). The mean age of patients with a solitary thyroid nodule (STN) was 40.57 years (SD: 13.65) and 45 years (SD: 14.49) for multinodular cases, with the number of nodules increasing with age (p = 0.0008). Malignancy was seen in 78% of STN cases and 73% of multinodular goiter (MNG) cases (p = 0.554). Comparing genders, 74.2% of female patients and 79.6% of male patients with an STN showed malignancy (p = 0.556). Similarly, 73.4% of females and 75.7% of males with MNG showed malignancy (p = 0.694). Multicentric malignancy was detected in 65.2% of MNG cases and 26.6% of STN cases (p < 0.001). This was especially prominent in papillary carcinomas, which had multicentric malignancy rates of 66.6% for MNG and 22.4% for STN (p < 0.001).

The females tended to develop nodules at an earlier age than the males, the MNG risk increased with age, and multicentric malignancy was prominent in MNG in papillary carcinomas.