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Different surgical techniques in the treatment of papillary thyroid cancer and factors associated with the presence of tumor recurrences

Abstract:

Introduction: There are different surgical techniques for thyroid cancer and the recurrence of this disease after said procedures has not been analyzed in our population. Therefore, the purpose of this research was to describe different surgical techniques and factors associated with recurrences in patients with papillary thyroid cancer. Materials and methods: An epidemiological, observational, retrospective analytical cohort study was carried out at the Carlos Andrade Marin Hospital in the city of Quito in the period between January 2005 and December 2015. This consisted of the collection of the data from 368 subjects with the diagnosis of papillary thyroid cancer, including their demographic characteristics and considering the diagnosis, treatment and evolution within the hospital. Results: A total of 368 patients were studied, consisting of 313 women (85.1%) and 55 men (14.9%). The mean age was 48.86 ± 13.07, 38% (n=140) were in the category of those younger than 45 years and 62% (n=228) in the group older than 45 years old. The factors that were associated with the presence of recurrence were lobectomy, enlarged thyroidectomy, complete neck dissection, radical neck dissection, high columnar histological variant, poor tumor differentiation, capsular invasion, vascular invasion, compromised margins, extrathyroid extension, prethyroid muscles, recurrent nerve injury, as well as trachea, larynx, pharynx and skin injury. Conclusion: An integral management of the patient with thyroid cancer should be performed and the surgery of choice should be defined in accordance with its characteristics. Similarly, the follow-up phase should be determined in those patients with the previously mentioned factors as they are in relationship with tumor recurrence.