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Differentiated Thyroid Carcinoma Long-Term Prognostic Factors.

Pacheco-Ojeda Luis1, Martínez-Jaramillo Ana Lucía2, Romo-Castillo Hugo3

  • 1Surgery Service Metropolitano Hospital, Quito, Ecuador.

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Differentiated thyroid cancer (DTC) is common in Ecuadorian women. Advanced age, extrathyroidal spread, metastasis at diagnosis, and advanced stage significantly increase mortality risk in surgically treated patients.

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Area of Science:

  • Oncology
  • Endocrinology
  • Epidemiology

Background:

  • Thyroid cancer is the most prevalent cancer among women in Ecuador.
  • Differentiated thyroid cancer (DTC), encompassing papillary and follicular types, requires understanding of its demographic and clinical profiles.

Purpose of the Study:

  • To determine the demographic, clinical, and treatment variables of differentiated thyroid cancer (DTC) patients.
  • To identify prognostic factors influencing survival in DTC patients treated at a tertiary hospital in Quito, Ecuador.

Main Methods:

  • Retrospective review of medical records for DTC patients who underwent surgery between 1990 and 2019.
  • Data collection included demographics, pathology, clinical stage, surgery type, and radioactive iodine (RAI) therapy.
  • Kaplan-Meier survival analysis and univariate/multivariate Cox proportional hazards models were employed.

Main Results:

  • Overall 5-, 10-, 20-, and 30-year survival rates were 93%, 85%, 70%, and 63%, respectively.
  • Univariate analysis identified numerous significant prognostic factors, including age, histology, tumor grade, stage, and treatment.
  • Multivariate analysis revealed age over 55, extrathyroidal spread, metastasis at diagnosis, and advanced clinical stage (II-IV) as independent predictors of increased mortality risk.

Conclusions:

  • Age over 55, extrathyroidal spread, metastasis at diagnosis, and advanced clinical stage are associated with a poorer prognosis in Ecuadorian DTC patients.
  • These factors significantly increase the risk of death in patients undergoing surgical treatment for differentiated thyroid cancer.