THYROID-CANCER - 20 YEARS EXPERIENCE AT A COMMUNITY-HOSPITAL

A retrospective analysis of 117 cases of thyroid cancer diagnosed and/ or treated at the Hospital Privado de Comunidad in Mar del Plata, Arge ntina, between 1974 and 1993 is presented and compared to previously p ublished reports. Mean age at diagnosis was 54.3 years (range 17-88). Follow-up was 8.2 +/- 5.7 years. One third of patients had a previous history of thyroid disease. Histologic types had frequencies comparabl e to other series: 67.5 % papillary, 15.4 % follicular, 6 % medullary, 3.4 % Hurthle-cell and 6.8 % undifferentiated. There was one case of lymphoma. Female to male ratio was 4.2:1 (95 females, 22 males).Higher age at diagnosis (over 63 years), higher tumor staging (TNM III or IV ) and histologic type (undifferentiated, Hurthle and medullary) were i mportant unfavorable prognostic factors for recurrence or death from t he disease, but sex, type of surgery, postoperative radiation and horm onal therapy were not. Undifferentiated carcinomas (n=8) had 100 % mor tality (survival 1-17 months after diagnosis, mean 5.5) and Hurthle-ce ll cancer had 75% mortality (survival 22-46 months, mean 33). Fine nee dle aspiration biopsy proved to be a useful diagnostic procedure, with an elevated positive predictive value (96%) and a moderate sensitivit y (75%). A gradual decrease in surgical complications was observed, th e last case of hypoparathyroidism occurring in 1986.