[A retrospective cohort study of patients diagnosed of thyroid cancer in the southwest Madrid area. Predictive factors in differentiated thyroid cancer]. / Estudio de cohorte retrospectivo de pacientes diagnosticados de cáncer de tiroides del área suroeste de Madrid. Factores pronósticos en el cáncer diferenciado de tiroides.

OBJECTIVES: To analyze the clinical and histopathological features of patients with thyroid cancer in the southwest Madrid area and to identify poor prognostic factors in the subgroup with differentiated thyroid carcinoma (DTC) of the follicular epitelium. PATIENTS AND METHODS: A retrospective cohort study of patients diagnosed with thyroid cancer at our hospital from 1998 to 2009. Significant clinical, surgical, and histopathological variables were included in Cox proportional hazard and logistic regression models to identify baseline factors predicting for death, recurrence, and persistent disease in DTC. RESULTS: A total of 150 patients with a median age of 49 years and a median follow-up of 5.4 years were enrolled. Histological subtypes were: papillary carcinoma (86%), follicular carcinoma (6.6%), medullary carcinoma (4%), poorly differentiated carcinoma (2.7%), and anaplastic carcinoma (0.7%). At the end of the study, 68% of patients were cured, 3.3% had died (disease-specific mortality, 1.3%), 1.3% were lost to follow-up, 6.7% had persistent biochemical disease, and 2.7% persistent clinical disease, while 18% of patients were pending assessment. The best prognostic model for DTC recurrence was TNM staging (stage II-IV vs. I: HR 5.9, 95% CI 1.3-26.6), while the best model for persistent disease or death was ETA clinical staging (high risk vs. low or very low risk: OR 9.2, 95% CI 2.6-33.2). CONCLUSIONS: In our study, disease-specific mortality and persistent clinical disease were low. Classification of DTC patients based on ETA staging after initial treatment was a good predictor of persistent disease or death.

Estudio de cohorte retrospectivo de pacientes diagnosticados de cáncer de tiroides del área suroeste de Madrid. Factores pronósticos en el cáncer diferenciado de tiroides / No disponible

Objetivos Análisis de las características clínicas e histopatológicas de los pacientes con cáncer de tiroides en el área suroeste de Madrid e identificación de los factores de mal pronóstico en el subgrupo de carcinoma diferenciado de tiroides (CDT) del epitelio folicular. Pacientes y métodos .Estudio retrospectivo de una cohorte de cáncer de tiroides de nuestro hospital entre 1998-2009. Las variables clínicas, quirúrgicas e histopatológicas significativas se incluyeron en modelos de regresión de Cox y logística para la identificación de factores pronósticos de muerte, recidiva y persistencia de enfermedad. Resultados Se incluyeron 150 pacientes con mediana de edad 49 años y mediana de seguimiento de 5,4 años. Los subtipos histológicos fueron: carcinoma papilar (86%), carcinoma folicular (6,6%), carcinoma medular (4%), carcinoma pobremente diferenciado (2,7%) y carcinoma anaplásico (0,7%).Al final del estudio: 68% curación, 3,3% muertos (mortalidad por cáncer tiroideo 1,3%), 1,3% pérdida de seguimiento, 6,7% con enfermedad bioquímica persistente, 2,7% con enfermedad clínica persistente y 18% pendiente de evaluación. El mejor modelo pronóstico para recidiva de CDT fue el estadiaje TNM (estadio ii-iv frente a i: HR 5,9, 95% IC 1,3-26,6) y para persistencia de enfermedad o muerte el estadiaje clínico de la ETA (alto riesgo frente a bajo/muy bajo riesgo: OR 9,2, 95% IC 2,6-33,2)Conclusiones En nuestro estudio la mortalidad y persistencia clínica de enfermedad fueron bajas. La clasificación de pacientes con CDT según estadiaje de la ETA fue un buen factor predictor de enfermedad persistente o muerte (AU)

Objectives To analyze the clinical and histopathological features of patients with thyroid cancer in the southwest Madrid area and to identify poor prognostic factors in the subgroup with differentiated thyroid carcinoma (DTC) of the follicular epitelium. Patients and methods A retrospective cohort study of patients diagnosed with thyroid cancer at our hospital from 1998 to 2009. Significant clinical, surgical, and histopathological variables were included in Cox proportional hazard and logistic regression models to identify baseline factors predicting for death, recurrence, and persistent disease in DTC. Results A total of 150 patients with a median age of 49 years and a median follow-up of 5.4 years were enrolled. Histological subtypes were: papillary carcinoma (86%), follicular carcinoma (6.6%), medullary carcinoma (4%), poorly differentiated carcinoma (2.7%), and anaplastic carcinoma (0.7%). At the end of the study, 68% of patients were cured, 3.3% had died (disease-specific mortality, 1.3%), 1.3% were lost to follow-up, 6.7% had persistent biochemical disease, and 2.7% persistent clinical disease, while 18% of patients were pending assessment. The best prognostic model for DTC recurrence was TNM staging (stage II-IV vs. I: HR 5.9, 95% CI 1.3-26.6), while the best model for persistent disease or death was ETA clinical staging (high risk vs. low or very low risk: OR 9.2, 95% CI 2.6-33.2).Conclusions In our study, disease-specific mortality and persistent clinical disease were low. Classification of DTC patients based on ETA staging after initial treatment was a good predictor of persistent disease or death (AU)