Table 1Clinical Profile of Patients with Differentiated Thyroid Cancer
Variable |
Differentiated thyroid cancer (n=728) |
Papillary thyroid cancer (n=649) |
Follicular thyroid cancer (n=79) |
Sex |
|
|
|
Female |
625 (85.9) |
553 (85.2) |
72 (91.1) |
Male |
103 (14.1) |
96 (14.8) |
7 (8.9) |
Age at diagnosis, yr |
44±13 |
43±13 |
44±13 |
<45 |
395 (54.3) |
355 (54.7) |
40 (50.6) |
>45 |
333 (45.7) |
294 (45.3) |
39 (49.4) |
18–30 |
136 (18.7) |
124 (19.1) |
12 (15.2) |
31–40 |
176 (24.2) |
158 (24.3) |
18 (22.8) |
41–50 |
192 (26.4) |
170 (26.2) |
22 (27.8) |
51–60 |
162 (22.2) |
145 (22.3) |
17 (21.5) |
61–70 |
54 (7.4) |
46 (7.1) |
8 (10.1) |
>70 |
8 (1.1) |
6 (0.9) |
2 (2.5) |
Duration of goiter, mo |
71±78 |
65±76 |
77±89 |
Family history of thyroid cancer |
11 (1.5) |
8 (1.2) |
2 (2.5) |
Prior neck irradiation |
0 |
0 |
0 |
Palpable lymph nodes at presentation |
131 (18.0) |
122 (18.8) |
9 (8.9) |
Distant metastases at presentation |
36 (4.9) |
26 (4.0) |
10 (12.7) |
Lungs |
21 (2.9) |
16 (2.5) |
5 (6.3) |
Bone |
21 (2.9) |
13 (2.0) |
8 (10.1) |
Spine |
1 (0.1) |
1 (0.2) |
0 |
Scalp |
0 |
0 |
1 (1.3) |
Associated comorbidities |
|
|
|
Diabetes |
60 (8.2) |
56 (8.5) |
4 (5.1) |
Hypertension |
187 (25.7) |
167 (25.7) |
20 (25.3) |
Lymphocytic thyroiditis |
41 (5.6) |
40 (6.2) |
1 (1.3) |
Graves disease/hyperthyroidism |
44 (6.0) |
41 (6.3) |
3 (3.8) |
Other malignancies |
21 (2.9) |
20 (3.1) |
1 (1.3) |
Breast cancer |
7 (1.0) |
7 (1.1) |
0 |
Table 2Histologic Profile of Patients with Well-Differentiated Thyroid Cancer
Variable |
Papillary thyroid cancer |
Follicular thyroid cancer |
Fine needle aspiration biopsy |
627 |
75 |
Benign |
276 (44.0) |
51 (68.0) |
Malignant |
351 (56.0) |
24 (32.0) |
Bethesda score |
|
|
1 |
0 |
0 |
2 |
274 (43.7) |
51 (68.0) |
3 |
2 (0.3) |
0 |
4 |
10 (1.6) |
16 (21.3) |
5 |
64 (10.2) |
3 (4.0) |
6 |
277 (44.2) |
5 (6.7) |
Final surgical histopathologic features |
649 |
79 |
Tumor size, cm |
2.9±2.0 |
3.5±1.9 |
Lymph node metastasis |
212 (32.7) |
6 (7.6) |
Multifocality |
152 (23.4) |
6 (7.6) |
Bilateral involvement |
114 (17.6) |
5 (6.3) |
Micropapillary cancer |
117 (18.0) |
- |
Follicular variant |
101 (15.6) |
- |
Tall cell variant |
5 (0.8) |
- |
Oncocytic variant |
1 (0.2) |
- |
Table 3Ultrasonographic Features of Well-Differentiated Thyroid Cancer
Variable |
Papillary thyroid cancer (n=610) |
Follicular thyroid cancer (n=74) |
Calcifications |
142 (23.3) |
15 (20.3) |
Hypoechogenicity |
466 (76.4) |
57 (77.0) |
Solid predominance |
503 (82.5) |
61 (82.4) |
Multinodularity |
484 (79.3) |
58 (78.4) |
Bilateral involvement |
381 (62.5) |
40 (54.1) |
Lymph node involvement |
140 (23.0) |
5 (6.8) |
Largest tumor size, cm |
3.3±2.1 |
3.3±2.1 |
Table 4Staging of Patients with Well-Differentiated Thyroid Cancer
Stage |
Papillary thyroid cancer (n=649) |
Follicular thyroid cancer (n=79) |
Initial staging |
Final staging |
Initial staging |
Final staging |
Revised cancer stage |
100 (15.4) |
11 (13.9) |
I |
410 (63.2) |
387 (59.6) |
43 (54.4) |
38 (48.1) |
II |
74 (11.4) |
78 (12.0) |
16 (20.3) |
18 (22.8) |
III |
97 (14.9) |
88 (13.6) |
9 (11.4) |
7 (8.9) |
IV-A |
50 (7.7) |
64 (9.9) |
1 (1.3) |
1 (1.3) |
IV-B |
5 (0.8) |
3 (0.5) |
0 |
0 |
IV-C |
13 (2.0) |
29 (4.5) |
10 (12.7) |
15 (19.0) |
TNM classification and staging |
|
|
|
|
T1 |
230 (35.4) |
228 (35.1) |
18 (22.8) |
18 (22.8) |
T2 |
268 (41.3) |
257 (39.6) |
36 (45.6) |
33 (41.8) |
T3 |
105 (16.2) |
103 (15.9) |
21 (26.6) |
20 (25.3) |
T4a |
40 (6.3) |
54 (8.3) |
4 (5.1) |
8 (10.1) |
T4b |
6 (0.9) |
7 (1.1) |
0 |
0 |
N0 |
455 (70.1) |
398 (61.3) |
73 (92.4) |
65 (82.3) |
N1a |
150 (23.1) |
173 (26.7) |
5 (6.3) |
8 (10.1) |
N1b |
44 (6.8) |
78 (12.0) |
1 (1.3) |
6 (7.6) |
M0 |
625 (96.3) |
595 (91.7) |
69 (87.3) |
61 (77.2) |
M1 |
24 (3.7) |
54 (8.3) |
10 (12.7) |
18 (22.8) |
Table 5Treatment Modalities Received by Patients with Well-Differentiated Thyroid Cancer
Variable |
Papillary thyroid cancer (n=649) |
Follicular thyroid cancer (n=79) |
Initial surgery |
|
|
Total thyroidectomy |
525 (80.9) |
54 (68.4) |
Near total thyroidectomy |
21 (3.2) |
1 (1.3) |
Subtotal thyroidectomy |
54 (8.3) |
15 (19.0) |
Lobectomy |
49 (7.6) |
9 (11.4) |
Nodal dissection |
168 (25.9) |
6 (7.6) |
2nd Surgery (completion) |
86 (13.3) |
17 (21.5) |
Interval from 1st surgery, mo |
18±43 |
7±9 |
Postsurgical hypoparathyroidism |
46 (7.1) |
5 (6.3) |
Radioactive iodine therapy |
465 (71.6) |
58 (73.4) |
Interval from total/completion surgery, mo |
6±9 |
12±26 |
TSH suppression therapy, |
465 (71.6) |
60 (75.9) |
External beam radiotherapy |
9 (1.4) |
6 (7.6) |
Chemotherapy |
1 (0.2) |
1 (1.3) |
Table 6Recurrence and Clinical Outcome of Patients with Well-Differentiated Thyroid Cancer
Variable |
Papillary thyroid cancer (n=649) |
Follicular thyroid cancer (n=79) |
Total follow-up duration, mo |
61±56 |
74±69 |
Overall recurrence |
212 (32.7) |
23 (29.1) |
Interval from surgery, mo |
30±43 |
49±57 |
Interval from RAI therapy, mo |
15±22 |
16±18 |
Elevated serum Tga
|
84 (39.6) |
9 (39.1) |
Nodal metastasis after 1st surgery |
161 (75.9) |
10 (43.5) |
Distant metastasis after 1st surgery |
47 (22.2) |
17 (73.9) |
Lungs |
35 (16.5) |
5 (21.7) |
Bones |
14 (6.6) |
5 (21.7) |
Repeated surgery |
47 (22.2) |
6 (26.1) |
Repeated RAI therapy |
142 (67.0) |
12 (69.6) |
Recurrence excluding M1 patients |
188/625 (30.1) |
13/69 (18.8) |
Mortality |
2 (0.3) |
2 (2.5) |
Table 7Comparison of Papillary Thyroid Cancers across Different International Studies
Variable |
Philippines (n=649) |
Korea (n=189) |
Japan (n=5,768) |
Age at presentation |
43 |
45 |
49 |
Female sex, % |
85.2 |
79.9 |
89.4 |
Tumor size, cm |
2.9 |
1.8 |
1.5 |
Extrathyroidal extension, % |
7.1 |
47.6 |
13 |
Nodal metastases, % |
29.9 |
31.2 |
20 |
Distant metastases, % |
3.7 |
0.5 |
2 |
Recurrence rate, % |
30.1 |
17.5 |
9.6 |
Table 8Comparison of Follicular Thyroid Cancers across Different International Studies
Variable |
Philippines (n=79) |
Korea (n=483) |
Austria (n=207) |
Age at presentation |
44 |
43 |
57.8 |
Female sex, % |
91.1 |
84.5 |
71.5 |
Tumor size, cm |
3.5 |
3.5 |
3.9 |
Extrathyroidal extension, % |
5.1 |
10 |
8.2 |
Nodal metastases, % |
7.6 |
3 |
7.7 |
Distant metastases, % |
12.7 |
8 |
18.4 |
Recurrence rate, % |
18.8 |
3 |
11.1 |