rome and Adenocarcinoma--Follicular

The study aims were to characterize patients with insular thyroid cancer and to provide data on patient outcome after surgical therapy. We compared nine patients with insular thyroid cancer at the Department of Surgical Science of "La Sapienza" University of Rome with 27 patients of similar age and tumor size who had follicular and papillary cancer, for a minimum follow-up period of 24 months (range, 24-72 months). All of the patients examined underwent total thyroidectomy. Vascular invasion was observed in 44.4 per cent of insular carcinomas (P < 0.05 vs papillary carcinomas). No significant differences were observed regarding diagnostic method, multifocality, tumor nodes metastases (TNM), or stage. The death rate of patients with insular carcinoma (33.3%) was found to be higher than that of patients with follicular carcinoma (P < 0.05) and papillary carcinoma (P < 0.01). Relapsing lymph-node pathologies were observed in 4 patients (44.4%) with insular carcinoma (P < 0.05 vs those with follicular and papillary carcinomas). Distant metastases were observed in 66.6 per cent of insular carcinomas (P < 0.005 vs follicular carcinoma and P < 0.001 vs papillary carcinoma). At the end of follow-up, 2 patients (22.2%) with insular carcinoma were disease-free (P < 0.001 vs those with follicular and papillary carcinomas). Our study demonstrates an unfavorable prognostic role of the insular phenotype of thyroid cancer, such that this tumor can be classified as an autonomous clinical and pathological entity.

Topics: Actuarial Analysis; Adenocarcinoma, Follicular; Adult; Aged; Carcinoma; Carcinoma, Papillary; Disease-Free Survival; Female; Follow-Up Studies; Hospitals, University; Humans; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasm Staging; Phenotype; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Rome; Survival Analysis; Thyroid Neoplasms; Thyroidectomy; Treatment Outcome

The aim of this investigation was to ascertain: 1) temporal trends in the incidence of thyroid carcinoma between 1990-1993; 2) regional differences in the incidence and histotype among the five provinces of Latium; 3) identification of risk factors, particularly of a preexisting thyroid tumour (goitre).. Records of patients submitted to thyroid surgery at the Istitute of III Clinica Chirurgica dell'Università "La Sapienza" di Roma have been reviewed and a questionnaire filled-in.. In the period 1990-1993, 144 cases of thyroid carcinomas were operated; 77.7% of those resided in the Latium region. Average age was 43 +/- 16.2, F:M = 3:1. During the four years observation period there was an increase in all surgical interventions and proportionally increased also thyroid surgery (hyperplasia, thyroiditis, hyperthyroidism and thyroid cancer). Thyroid cancer was found in 10% of thyroid patients, this proportion remains constant in the period 1990-1992, in 1993 rising to 14% (p = 0.032). Differences of incidence although not significant were found in the five provinces of Latium. A higher proportion of follicular histotypes was found in the province of Frosinone (FR vs RM, 20 vs 13.5% p = 0.45). A previous goitre, standing for period of three or more years, was reported in the records of 25% of patients. Seven percent of patients have been previously submitted to a partial thyroidectomy for benign thyroid disease, most of those being operated for thyroid adenoma (8 out 10 cases).. During a four year period of observation an increase of thyroid carcinoma was observed only in 1993. This increase cannot be attributed to an increase in the incidence of thyroid carcinoma. The province of Frosinone, known to be an endemic area, shows a proportion of the follicular histotype higher than that of other provinces. Goiter precedes malignant thyroid neoplasia in a high proportion of patients (25%). Follicular adenoma found frequently at the histology of patients operated for benign thyroid disease suggesting a transformation from benign to a malignant condition.

Topics: Adenocarcinoma, Follicular; Adult; Carcinoma, Papillary; Female; Humans; Incidence; Italy; Male; Medical Records; Middle Aged; Retrospective Studies; Rome; Thyroid Diseases; Thyroid Neoplasms; Thyroidectomy; Time Factors