RESUMO
BACKGROUND: Anaplastic thyroid carcinoma (ATC) is relatively rare and represents one of the most aggressive tumours with poor prognosis, despite therapy. The aim of the study was to analyse demographic and clinical characteristics of ATC patients, and to identify survival rates and prognostic factors. METHODS: In a retrospective study (1995-2005) ATC was found in 150 patients treated at our institution. Survival was calculated by Kaplan-Meier curve and log-rank test. Potential prognostic factors affecting survival were compared by Cox univariate and multivariate analyses. RESULTS: Mean survival time was 56 weeks; median survival time was 16 weeks and 1 and 5-year survival were 17% and 8%. More than 10% died during the first month and 50% died up to the fourth month. Multivariate analysis showed that age, goitre and surgery were independent prognostic factors of survival in all ATC patients. Among operated patients, the extent of tumour resection, distant metastasis and multicentricity were independent prognostic risk factors of survival. Postoperative radiotherapy was a protective factor. CONCLUSIONS: There is still no successful treatment of ATC that can guarantee long term survival. Younger patients with pre-existing goitre, who undergo complete resection of unilocular early stage ATC without distant metastasis and with postoperative external radiotherapy, stand a better chance of long-term survival.
Assuntos
Carcinoma Anaplásico da Tireoide/diagnóstico , Carcinoma Anaplásico da Tireoide/mortalidade , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/mortalidade , Adulto , Fatores Etários , Idoso , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Taxa de Sobrevida , Carcinoma Anaplásico da Tireoide/terapia , Neoplasias da Glândula Tireoide/terapia , TireoidectomiaRESUMO
BACKGROUND: Anaplastic thyroid carcinoma (ATC) is relatively rare and represents one of the most aggressive tumours with poor prognosis, despite therapy. The aim of the study was to analyse demographic and clinical characteristics of ATC patients, and to identify survival rates and prognostic factors. METHODS: In a retrospective study (1995-2005) ATC was found in 150 patients treated at our institution. Survival was calculated by Kaplan-Meier curve and log-rank test. Potential prognostic factors affecting survival were compared by Cox univariate and multivariate analyses. RESULTS: Mean survival time was 56 weeks; median survival time was 16 weeks and 1 and 5-year survival were 17% and 8%. More than 10% died during the first month and 50% died up to the fourth month. Multivariate analysis showed that age, goitre and surgery were independent prognostic factors of survival in all ATC patients. Among operated patients, the extent of tumour resection, distant metastasis and multicentricity were independent prognostic risk factors of survival. Postoperative radiotherapy was a protective factor. CONCLUSIONS: There is still no successful treatment of ATC that can guarantee long term survival. Younger patients with pre-existing goitre, who undergo complete resection of unilocular early stage ATC without distant metastasis and with postoperative external radiotherapy, stand a better chance of long-term survival.
Assuntos
Causas de Morte , Carcinoma Anaplásico da Tireoide/mortalidade , Carcinoma Anaplásico da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/mortalidade , Neoplasias da Glândula Tireoide/cirurgia , Adulto , Análise de Variância , Biópsia por Agulha , Estudos de Coortes , Intervalo Livre de Doença , Feminino , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Medição de Risco , Taxa de Sobrevida , Carcinoma Anaplásico da Tireoide/patologia , Neoplasias da Glândula Tireoide/patologiaRESUMO
BACKGROUND: Phaeochromocytoma and paraganglioma resection carries a high perioperative risk. The aim of this study was to determine the risk factors for and frequency of perioperative morbidity and mortality during resection of these tumours. METHODS: Computerized surgical, medical, and histopathology records, as well as anaesthesia cards for 145 patients undergoing surgery for phaeochromocytoma resection between 1995 and 2009 were analysed retrospectively. Preoperative notes, adverse intraoperative events, and postoperative complications occurring in the 30 days following surgery were recorded. Preoperative phenoxybensamine and propranolol dose, age, sex, ASA score, catecholamine urinary level and profile, tumour weight, duration of surgery, and malignancy and presence of bilateral tumours were investigated to determine their contribution to major intraoperative haemodynamic events. Univariate comparisons were carried out using the student t-test. The Mann-Whitney test was also used to allow for deviation from normality. Logistic regression with backward removal of insignificant variables was used for multivariate analysis. Spearman test was used for correlation analysis. RESULTS: The only statistically significant factor that increased the probability of intraoperative haemodynamic variability was the duration of surgery (p = 0.025). The most common intraoperative event was transient hypertension, occurring in 59 (40.7%) patients. Sustained hypertension was registered in only 10 (6.9%) patients. No mortality, myocardial infarction, or cerebrovascular incidents were recorded. CONCLUSIONS: We found that the severity of perioperative haemodynamic changes significantly correlated with the duration of surgery. Our patients had low perioperative morbidity and no mortality.
Assuntos
Neoplasias das Glândulas Suprarrenais/cirurgia , Feocromocitoma/cirurgia , Adulto , Idoso , Catecolaminas/urina , Feminino , Hemodinâmica , Humanos , Hipertensão/etiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Paraganglioma/cirurgia , Período Perioperatório , Feocromocitoma/fisiopatologia , Complicações Pós-Operatórias , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do TratamentoRESUMO
Thyroid microcarcinoma are well-differentiated tumors less than 1 cm in diameter. A retrospective analysis was performed on patients operated of benign thyroid disease at the Center for endocrine surgery, Institute of endocrinology, Clical Center of Serbia in Belgrade, from January 1st to December 31st 2004, in order to establish the incidence of microcarcinoma. Indications for surgery were euthyroid multinodular goiter in 201 patients, thyroiditis in 31, thyroid adenoma in 178, Graves disease in 89 and Plummers disease in 79 patients. The results of this study, demonstrate that in 13.4% of the patients operated for goiter, 6.4% operated for thyroiditis, 5.6% for thyroid adenomas, 9.0% for Graves disease and 7.0% of the patients operated for Plumers disease, the presence of a microcarcinoma was noticed in the definitive histopathologic examination. The results obtained are in line with the current knowledge of high incidence of thyroid microcarcinoma.
Assuntos
Achados Incidentais , Doenças da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , TireoidectomiaRESUMO
A case-control study comprised 177 patients with various types of thyroid cancer and the same number of hospital controls individually matched by age, sex and place of residence. Malignant tumors were more frequent among first and second degree relatives of cases as compared to controls. The odds ratio (95% confidence interval) was 2.43 (1.33-4.44) and 5.33 (1.77-16.01) respectively. The most frequent were cancers of uterus and stomach with odds ratio of 6.00 (1.61-22.36) and 9.00 (1.64-49.35). Thyroid cancer was present only in first-degree relatives of two cases and none of controls.
Assuntos
Neoplasias/genética , Neoplasias da Glândula Tireoide/genética , Adenocarcinoma/genética , Adenocarcinoma Folicular/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anaplasia , Carcinoma Medular/genética , Carcinoma Papilar/genética , Estudos de Casos e Controles , Criança , Intervalos de Confiança , Meio Ambiente , Saúde da Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Neoplasias Gástricas/genética , Neoplasias Uterinas/genética , IugosláviaRESUMO
Case-control study comprised 100 histologically verified thyroid cancer patients (23 men, 77 women) and 100 hospital controls matched with cases by sex, age and place of residence. Various risk factors were studied to determine whether they were associated with the occurrence of thyroid cancer. According to the conditional logistic regression analysis, 6 were significantly related to the disease: Cigarette smoking (RR = 7.12 95% CI = 1.53-32.99), family history of any malignant tumors (RR = 5.84 95% CI = 1.76-19.44), history of goiter or thyroid nodules (RR = 27.69 95% CI = 3.11-246.14), long-term occupational exposure to chemicals (RR = 10.07 95% CI = 3.85-26.35), history of second primary tumors (RR = 15.49 95% CI = 3.46-69.30), and diagnostic X-rays exposure (RR = 7.56 95% CI = 2.85-20.07).