Differentiated thyroid cancer in Iran - initial observations, histological features, management of the disease, and tumor recurrence: A review of 1689 cases

Abstract

AIM: The main objective of this study was to define some histopathological aspects of differentiated thyroid cancer (DTC), describe the disease management, and evaluate potential predicting factors for tumor recurrence in Iran. MATERIALS AND METHODS: Medical records of 1689 patients of DTC treated over a 15-year period at a referral hospital located in the central region of Iran were reviewed retrospectively. RESULTS: The female/male ratio was 3.78. The mean size of tumors was 23.35 mm. Most patients had papillary thyroid cancer (PTC) followed by follicular thyroid cancer (FTC) (83 and 5.5, respectively). Lymph node involvement was seen in 27.6 of patients, and 3.6 of them had distant metastasis. Tumor recurrence was reported in 36.4 of patients. Higher stages of cancer, presence of lymph node involvement, presence of distant metastasis, larger tumor size, history of goiter, and higher doses of 131-Iodine at the first admission were associated with more chance of recurrence (P < 0.05). Comparing features of PTC and FTC, we found a more invasive behavior in FTC patients, including more capsular and near tissue invasion, higher stages of cancer, more frequent distant metastasis, and larger tumor size. CONCLUSION: This study provides useful information on characteristics of DTC, its management, and some prognostic factors. Our findings suggest that higher stages of cancer at diagnosis, presence of lymph node involvement, presence of distant metastasis, larger tumor size, history of goiter, and higher doses of 131-iodine administered at the first admission are associated with more chance of tumor recurrence. Furthermore, we found that FTC follows a more aggressive behavior and recommends clinicians to handle FTC patients more cautiously.