Format

Send to

Choose Destination
See comment in PubMed Commons below
Arch Otolaryngol Head Neck Surg. 2009 Apr;135(4):355-9. doi: 10.1001/archoto.2009.13.

Influence of previous radiation exposure on pathologic features and clinical outcome in patients with thyroid cancer.

Author information

1
Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, 600 University Ave, Ste 401, Toronto, ON M5G 1X5, Canada.

Abstract

OBJECTIVE:

To determine whether previous radiation exposure to the head and neck is related to less favorable pathologic and clinical outcome in patients after surgical management of thyroid cancer.

DESIGN:

Retrospective chart review.

SETTING:

Academic teaching hospital (referral center).

PATIENTS:

All patients with diagnosed thyroid cancer who had been exposed to radiation before surgical treatment were retrospectively identified from the thyroid cancer database at our institution (1963-2007). One hundred twenty-five patients (95 women and 30 men) were included. Inclusion criteria included surgical treatment for thyroid cancer and a history of exposure to radiation at least 3 years before diagnosis of the disease.

MAIN OUTCOME MEASURES:

Pathologic features and data related to disease recurrence, distant metastasis, and survival.

RESULTS:

Mean (range) age at first exposure to radiation was 19.4 (1-65) years, and mean lag time to diagnosis of disease was 28.7 (3-60) years. Patients were treated surgically with either total or near-total thyroidectomy (83%) or partial or subtotal thyroidectomy (17%). Pathologic diagnoses included 111 papillary carcinomas (89%). Sixty-three percent of patients had multifocal disease, 12% had lymphovascular tumor invasion, and 26% had direct extrathyroid extension of disease. Twenty-five percent of patients had metastases to cervical lymph nodes, and 9% had distant metastases. Sixteen percent of patients experienced local recurrence of disease. At last follow-up, 86% of patients were alive and free of disease, 8% were alive with disease, 4% had died of thyroid cancer, and 2% had died of an unrelated cause. Compared with other patients with thyroid cancer, this radiation-exposed cohort was more likely to undergo total thyroidectomy, multiple operative procedures, and external radiotherapy. A higher percentage had multifocal disease, extrathyroid extension, stage IV disease, and distant metastases. At follow-up, fewer patients were free of disease, and more patients had died of thyroid disease.

CONCLUSION:

Patients who have been exposed to radiation have more aggressive disease and worse clinical outcome than other patients with thyroid cancer.

PMID:
19380356
DOI:
10.1001/archoto.2009.13
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Silverchair Information Systems
    Loading ...
    Support Center