5-year analysis of thyroidectomies; a retrospective clinicopathological assessment of papillary carcinoma of thyroid in a coastal urban area

Abstract

INTRODUCTIONThyroid surgery was pioneered by surgeons such as Billroth, Kocher, Crile, Lahey and Dunhill.1 Kocher performed 5,000 operations with a mortality rate of 0.5%. 2The main complications associated with thyroidectomy are hypoparathyroidism and recurrent laryngeal nerve. The prevalence of thyroid nodules varies from 4-8% in adults by palpation. Autopsy studies have shown a prevalence of thyroid nodules in 50 %. 3,4 The prevalence increases in endemic areas, women and with increase of age. Only five percent of thyroid nodules will have cancer. 5 The risk of malignancy does not differ either in solitary nodule or multinodular goiter. The prevalence of thyroid cancer (TC) is rising.6 Papillary thyroid carcinoma (PTC) is the most common thyroid cancer, it presents relatively as a low-grade malignancy with good prognosis, and a 10-year survival rate of over 90%. However, the clinical behaviors of this cancer are complex.Department of General Surgery, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India Received: 10 January 2018 Accepted: 15 January 2018 *Correspondence: Dr. Ahmed Pervez, E-mail: dr_ahmed_pervez@yahoo.co.in Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background:The aim of our study was to analyse thyroidectomies done past 5 years on a clinico pathological basis. Additionally, we also wanted to study the presence and characteristics of papillary carcinoma of thyroid. Methods: Retrospective analysis of 57 patients who underwent thyroidectomy from 2012 to 2017 performed by Department of General Surgery of Sri Ramachandra Medical College (Chennai, India) was done and checked for statistical significance. Results: In this 5-year study of 57 thyroidectomies, 17 patients had papillary carcinoma of thyroid, 1 patient had anaplastic carcinoma and another patient had a thyroid metastasis with unknown primary. The nonmalignant 38 patients were studied separately. Regarding malignancy, 29.4% had micro carcinoma. 35.3% were in Stage I. 94.1% were in Grade I, 94.1% had no angioinvasion. 15 patients (88.2%) had negative capsule invasion and negative lympho vascular invasion. 4 patients (23.5%) had extra thyroid extension. The observed difference in the characteristics were statistically not significant (p>0.05). The odds ratio for micro carcinoma of thyroid was 0.364. Most common clinical diagnosis among patients with benign disease was multinodular goiter and 16 (40%) patients had total thyroidectomy. 82.5% of patients had microscopic nodules on histopathology. The association between the surgery type and clinical diagnosis was statistically significant (p<0.001). Conclusions: Statistical significance was noted between surgery type and clinical diagnosis. Papillary carcinoma of thyroid is not rare even in non endemic...