CANCER TIROIDEO RECURRENTE Diagnóstico, tratamiento y riesgo de supervivencia

Abstract

Background: 8 to 23% of patients suffering CDT have a recurrence. Two third parties in the following 10 years after treatment. However, large part of patients have good survival.

Objective: to analize risk factors of survival in recurred CDT after treatment.

Design: Retrospective - Observational.

Setting: Public tertiary care head and neck referral center.

Population: 114 patients with mean age 58.31 years old and 2.1 men by each one woman. 81.5% was papillary and 12.2% follicular carcinoma. In 44/114 of own serie, a total thyroidectomy was performed, extended to de lateral neck in 27.26% and trachea in 6.8%. In the rest, 50% received thyroidectomy less than total, 48.5% total thyroidectomy extended to the lateral neck in 11.7% and the trachea in 5.8%.

Methods: More frequent endoscopy was telelaryngoscopy followed by fibrobronchoscopy and high digestive endoscopy. Computed tomography, magnetic resonance and 131I scanning were images frequently used. 24.5% of patients had a recurrent locally invasive carcinoma. Surgery of recurrence was extended to cervical nodes in 94.7%, to high respiratory tract in 10.5%, to the muscles in 7.9% and it was only local in 5.2%. In 35 patients thyroidectomy was completed.

Results: Surgery was accompanied of 24.5% complications, specially hipocalcemia in 16. 11 sequelas were reported, specially definitive hipocalcemia in 6 and recurrent laryngeal nerve paralysis in 3. 14/114 had more than 1 recurrence. In multivariate analysis age<45 years old and well-differentiated neoplasias were statiscally significative with p: 0.007 and 0.005 respectively. Survival was 70% a 5 years.