Incidental diagnosis and surgery outcomes of thyroid cancer in Ecuador

Abstract Background: In contrast to the rapid increase in thyroid cancer (TC) incidence, thyroid cancer mortality rates have remained low and stable over the last decades. In Ecuador, however, TC mortality has increased and to determine possible drivers, a retrospective analysis of all patients attending a thyroid cancer referral center in Ecuador was conducted. Methods: From June 2014 to December 2017, a cross-sectional study was conducted at the Hospital de Especialidades Eugenio Espejo (HEEE), a regional reference public hospital for endocrine neoplasia in adults in Quito, Ecuador. We identified the mechanism of detection, histopathology and treatment modalities from a patient interview and review of clinical records. Results: Among 452 patients, 74.8% were young adults and 94.2% (426) of patients were female. 13.7% had a family history of thyroid cancer, and median of tumor size was 2 cm. The incidental finding was 54.2% whereas 45.8% was non-incidental. Thyroid cancer histology reported that 93.3% had papillary thyroid cancer (PTC), 2.7% follicular, 1.5% Hurtle cells, 1.6% medullary, 0.7% poor differentiated, and 0.2% anaplastic carcinoma. The mean MACIS (metastasis, age, completeness, invasion, and size) score was 4.95 (CI 4.15-5.95) with 76.2% of the thyroid cancer patients having MACIS score equal or less than 6. The very low and low risk of recurrence was 18.1% (79) and 62% (271) respectively. An analysis of 319 patients with non-metastatic thyroid cancer showed that 10.7% (34) of patients had surgical complications. Moreover, around 62.5% (80 from 128 patients with thyroglobulin laboratory results) of TC patients had a stimulated-thyroglobulin (sTg) value equal or higher than 2 ng/ml. Overall, a poor surgical outcome was present in 35.1% (112) patients. Out of 436 patients with differentiated thyroid carcinoma (DTC), 86% (n=375) received radioactive iodine (RAI). Conclusion: Thyroid cancer histological characteristics and method of diagnosis are like the ones described in other reports without any evidence of the high frequency of aggressive thyroid cancer histology. However, we observed evidence of overtreatment and poor surgical outcomes that demand additional studies to understand their association with thyroid cancer mortality in Ecuador.

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Thyroid cancer overdiagnosis and overtreatment: a cross- sectional study at a thyroid cancer referral center in Ecuador

BMC Cancer ◽

10.1186/s12885-020-07735-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Paola Solis-Pazmino ◽

Jorge Salazar-Vega ◽

Eddy Lincango-Naranjo ◽

Cristhian Garcia ◽

Gabriela Jaramillo Koupermann ◽

...

Keyword(s):

Thyroid Cancer ◽

Cancer Mortality ◽

Incidental Finding ◽

Cross Sectional Study ◽

Anaplastic Carcinoma ◽

Treatment Modalities ◽

Sectional Study ◽

Cross Sectional ◽

Referral Center ◽

Clinical Records

Abstract Background In contrast to the rapid increase in thyroid cancer incidence, the mortality has remained low and stable over the last decades. In Ecuador, however, thyroid cancer mortality has increased. The objective of this study is to determine possible drivers of high rates of thyroid cancer mortality, through a cross-sectional analysis of all patients attending a thyroid cancer referral center in Ecuador. Methods From June 2014 to December 2017, a cross-sectional study was conducted at the Hospital de Especialidades Eugenio Espejo, a regional reference public hospital for endocrine neoplasia in adults in Quito, Ecuador. We identified the mechanism of detection, histopathology and treatment modalities from a patient interview and review of clinical records. Results Among 452 patients, 74.8% were young adults and 94.2% (426) were female. 13.7% had a family history of thyroid cancer, and patients’ median tumor size was 2 cm. The incidental finding was 54.2% whereas 45.8% was non-incidental. Thyroid cancer histology reported that 93.3% had papillary thyroid cancer (PTC), 2.7% follicular, 1.5% Hurtle cells, 1.6% medullary, 0.7% poor differentiated, and 0.2% anaplastic carcinoma. The mean MACIS (metastasis, age, completeness, invasion, and size) score was 4.95 (CI 4.15–5.95) with 76.2% of the thyroid cancer patients having MACIS score less than or equal to 6. The very low and low risk of recurrence was 18.1% (79) and 62% (271) respectively. An analysis of 319 patients with non-metastatic thyroid cancer showed that 10.7% (34) of patients had surgical complications. Moreover, around 62.5% (80 from 128 patients with thyroglobulin laboratory results) of TC patients had a stimulated-thyroglobulin value equal or higher than 2 ng/ml. Overall, a poor surgical outcome was present in 35.1% (112) patients. Out of 436 patients with differentiated thyroid carcinoma, 86% (375) received radioactive iodine. Conclusion Thyroid cancer histological characteristics and method of diagnosis are like those described in other reports without any evidence of the high frequency of aggressive thyroid cancer histology. However, we observed evidence of overtreatment and poor surgical outcomes that demand additional studies to understand their association with thyroid cancer mortality in Ecuador.

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Thyroid Cancer Overdiagnosis and Overtreatment: a cross- sectional study at a thyroid cancer referral center in Ecuador

10.21203/rs.2.16716/v2 ◽

2020 ◽

Author(s):

Paola Solis-Pazmino ◽

Jorge Salazar-Vega ◽

Eddy Lincango-Naranjo ◽

Cristhian Garcia ◽

Gabriela Jaramillo Koupermann ◽

...

Keyword(s):

Thyroid Cancer ◽

Cancer Mortality ◽

Incidental Finding ◽

Cross Sectional Study ◽

Anaplastic Carcinoma ◽

Treatment Modalities ◽

Sectional Study ◽

Cross Sectional ◽

Referral Center ◽

Clinical Records

Abstract Background: In contrast to the rapid increase in thyroid cancer (TC) incidence, thyroid cancer mortality has remained low and stable over the last decades. In Ecuador, however, TC mortality has increased. The objective of this study is to determine possible drivers of high rates of thyroid cancer mortality, through a cross-sectional analysis of all patients attending a thyroid cancer referral center in Ecuador.Methods: From June 2014 to December 2017, a cross-sectional study was conducted at the Hospital de Especialidades Eugenio Espejo (HEEE), a regional reference public hospital for endocrine neoplasia in adults in Quito, Ecuador. We identified the mechanism of detection, histopathology and treatment modalities from a patient interview and review of clinical records. Results: Among 452 patients, 74.8% were young adults and 94.2% (426) were female. 13.7% had a family history of thyroid cancer, and patients’ median tumor size was 2 cm. The incidental finding was 54.2% whereas 45.8% was non-incidental. Thyroid cancer histology reported that 93.3% had papillary thyroid cancer (PTC), 2.7% follicular, 1.5% Hurtle cells, 1.6% medullary, 0.7% poor differentiated, and 0.2% anaplastic carcinoma. The mean MACIS (metastasis, age, completeness, invasion, and size) score was 4.95 (CI 4.15-5.95) with 76.2% of the thyroid cancer patients having MACIS score less than or equal to 6. The very low and low risk of recurrence was 18.1% (79) and 62% (271) respectively. An analysis of 319 patients with non-metastatic thyroid cancer showed that 10.7% (34) of patients had surgical complications. Moreover, around 62.5% (80 from 128 patients with thyroglobulin laboratory results) of TC patients had a stimulated-thyroglobulin (sTg) value equal or higher than 2 ng/ml. Overall, a poor surgical outcome was present in 35.1% (112) patients. Out of 436 patients with differentiated thyroid carcinoma (DTC), 86% (375) received radioactive iodine (RAI). Conclusion: Thyroid cancer histological characteristics and method of diagnosis are like those described in other reports without any evidence of the high frequency of aggressive thyroid cancer histology. However, we observed evidence of overtreatment and poor surgical outcomes that demand additional studies to understand their association with thyroid cancer mortality in Ecuador.

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Thyroid Cancer Overdiagnosis and Overtreatment: a cross- sectional study at a thyroid cancer referral center in Ecuador

10.21203/rs.2.16716/v3 ◽

2021 ◽

Author(s):

Paola Solis-Pazmino ◽

Jorge Salazar-Vega ◽

Eddy Lincango-Naranjo ◽

Cristhian Garcia ◽

Gabriela Jaramillo Koupermann ◽

...

Keyword(s):

Thyroid Cancer ◽

Cancer Mortality ◽

Incidental Finding ◽

Cross Sectional Study ◽

Anaplastic Carcinoma ◽

Treatment Modalities ◽

Sectional Study ◽

Cross Sectional ◽

Referral Center ◽

Clinical Records

Abstract Background: In contrast to the rapid increase in thyroid cancer incidence, the mortality has remained low and stable over the last decades. In Ecuador, however, thyroid cancer mortality has increased. The objective of this study is to determine possible drivers of high rates of thyroid cancer mortality, through a cross-sectional analysis of all patients attending a thyroid cancer referral center in Ecuador.Methods: From June 2014 to December 2017, a cross-sectional study was conducted at the Hospital de Especialidades Eugenio Espejo, a regional reference public hospital for endocrine neoplasia in adults in Quito, Ecuador. We identified the mechanism of detection, histopathology and treatment modalities from a patient interview and review of clinical records. Results: Among 452 patients, 74.8% were young adults and 94.2% (426) were female. 13.7% had a family history of thyroid cancer, and patients’ median tumor size was 2 cm. The incidental finding was 54.2% whereas 45.8% was non-incidental. Thyroid cancer histology reported that 93.3% had papillary thyroid cancer (PTC), 2.7% follicular, 1.5% Hurtle cells, 1.6% medullary, 0.7% poor differentiated, and 0.2% anaplastic carcinoma. The mean MACIS (metastasis, age, completeness, invasion, and size) score was 4.95 (CI 4.15-5.95) with 76.2% of the thyroid cancer patients having MACIS score less than or equal to 6. The very low and low risk of recurrence was 18.1% (79) and 62% (271) respectively. An analysis of 319 patients with non-metastatic thyroid cancer showed that 10.7% (34) of patients had surgical complications. Moreover, around 62.5% (80 from 128 patients with thyroglobulin laboratory results) of TC patients had a stimulated-thyroglobulin value equal or higher than 2 ng/ml. Overall, a poor surgical outcome was present in 35.1% (112) patients. Out of 436 patients with differentiated thyroid carcinoma, 86% (375) received radioactive iodine. Conclusion: Thyroid cancer histological characteristics and method of diagnosis are like those described in other reports without any evidence of the high frequency of aggressive thyroid cancer histology. However, we observed evidence of overtreatment and poor surgical outcomes that demand additional studies to understand their association with thyroid cancer mortality in Ecuador.

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Relationship Between Thyroid Cancer and Hashimoto's Disease

ESPOCH Congresses: The Ecuadorian Journal of S.T.E.A.M. ◽

10.18502/espoch.v1i6.9660 ◽

2021 ◽

Author(s):

Marcelo Ramiro Montúfar Silva ◽

Jessica Paola Cevallos Montalvo ◽

Byron Mauricio Sánchez Andino ◽

María Johanna Jima Sanchez ◽

Cecilia Alejandra García Ríos

Keyword(s):

Thyroid Cancer ◽

Hashimoto’S Thyroiditis ◽

Cross Sectional Study ◽

Hashimoto's Thyroiditis ◽

Cross Sectional ◽

Palabras Clave ◽

Laboratory Results ◽

History Of ◽

Clinical Records ◽

The Relationship

Introduction: Globally, Ecuador ranks fifth among the countries with the highest incidence of thyroid carcinoma in women, below Korea, Brazil, Italy and New Celedonia. The aim of this research was to mention the relationship between thyroid cancer and Hashimoto's thyroiditis at Pablo Arturo Suárez Hospital in Quito in the years 2014 to 2017. Methodology: A cross sectional study was conducted. The data were taken from the clinical records in the statistical service, 105 cases of thyroid cancer were found. In the laboratory results 21 patients had anti TPO and/or anti TG positive antibodies. Conclusion: 20% of patients with thyroid cancer had a history of Hashimoto's thyroiditis. Keywords: thyroid cancer, Hashimoto's thyroiditis, autoimmune thyroiditis. RESUMEN Introducción: A nivel mundial el Ecuador ocupa el quinto lugar entre los países con mayor incidencia de carcinoma de tiroides en mujeres, por debajo de Corea, Brasil, Italia y Nueva Celedonia. Objetivo: El objetivo de la presente investigación fue mencionar la relación entre cáncer de tiroides y tiroiditis de Hashimoto en el Hospital Pablo Arturo Suárez de la ciudad de Quito en los años 2014 a 2017. Metodología: se desarrolló un estudio de tipo transversal los datos se tomaron de los expedientes clínicos en el servicio de estadística, donde se encontró 105 casos de estudios histopatológicos compatibles con neoplasia tiroidea. Resultados: En los resultados de laboratorio se evidenció que 21 pacientes tuvieron anticuerpos anti TPO y/o anti TG positivos. Conclusión: El 20% de pacientes con cáncer de tiroides tuvieron antecedente de enfermedad autoinmune tiroidea. Palabras clave: cáncer de tiroides, tiroiditis de Hashimoto, tiroiditis autoinmune.

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POS1274 THERAPEUTIC MANAGEMENT OF RHEUMATOLOGISTS VERSUS OTORHINOLARYNGOLOGISTS OF CERVICOGENIC DIZZINESS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2230 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 921.2-922

Author(s):

M. Yasmine ◽

K. Maatallah ◽

H. Ferjani ◽

W. Triki ◽

D. Ben Nsib ◽

...

Keyword(s):

Physical Therapy ◽

Treatment Approach ◽

Cross Sectional Study ◽

Treatment Modalities ◽

Sectional Study ◽

Cross Sectional ◽

Standard Assessment ◽

Number Of Patients ◽

Cervicogenic Dizziness ◽

No Gold Standard

Background:The treatment of patients presenting with cervicogenic dizziness (CGD) may be challenging. Indeed, there is no consensual treatment approach for CGD, nor is there no gold-standard assessment for diagnosis.Objectives:Our study aimed to assess the management of CGD by rheumatologists versus otorhinolaryngologists.Methods:We conducted a cross-sectional study including Tunisian doctors dealing with CGD. Rheumatologists (RTO) and otorhinolaryngologists (ORL) were invited to answer a questionnaire via google form about CGD daily management. Outcomes of interest were treatment modalities.Results:The study included 30 RTO and 32 ORL. Most of the doctors (RTO, vs ORL) were females (88.3%, vs 56.3%), aged between 35 and 45 (43.3%, vs 62.5%), and worked at a private practice (33.3%, vs 59.4%). The number of patients diagnosed with CGD by RTO was as follows: 1-2 per year (33.3%), 1-2 per month (18.8%), 1-2 per week (20%), less than one patient a year (10%) and none in 3.3% of cases. The number of patients diagnosed with CGD by ORL was as follows: 1-2 per year (50%), 1-2 per month (33.3%), 1-2 per week (6.2%), less than one patient a year (15.7%) and none (9.4%). Most patients presenting with CGD were females in both groups (93.1%, vs 82.8% respectively) with a mean age between 36 and 65 (79.3%, vs 82.1%). Most of the respondents declared treating patients with CGD (93.1%, vs 79.1%). Regarding treatment modalities, physical therapy was the most prescribed in both specialties (81.5% and 48.3%, respectively). Only RTO (18.5%) prescribed manual therapy. Concerning medical treatment, anti-inflammatory were the most prescribed drugs in both groups (92.6, and 34.5%, respectively). Sixty-seven percent of RTO prescribed anti-vertigo medication. Interestingly, it was the least prescribed drug by ORL (6.9%). Only RTO (59.3%) prescribed Muscle relaxants.Conclusion:Despite the disparities in the management of CGD, physical therapy remains the first prescribed treatment by Tunisian doctors. Further studies are needed to establish a consensus to treat CGD.Disclosure of Interests:None declared

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Prevalence of thyroid cancer in patients with acromegaly and non-growth hormone secreting pituitary adenomas: A prospective cross-sectional study

Growth Hormone & IGF Research ◽

10.1016/j.ghir.2021.101378 ◽

2021 ◽

Vol 56 ◽

pp. 101378

Author(s):

Isadora Yasbick Spricido ◽

Carolina Monteguti Feckinghaus ◽

Rômulo Henrique Malaquias Silva ◽

Cleo Otaviano Mesa Junior ◽

Cesar Luiz Boguszewski

Keyword(s):

Growth Hormone ◽

Thyroid Cancer ◽

Pituitary Adenomas ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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A year of hepatocellular carcinoma at a glance. Demographics, biochemical and radiological characteristics and treatment modalities from a specialized facility of Pakistan

Journal of the Pakistan Medical Association ◽

10.47391/jpma.826 ◽

2021 ◽

pp. 1-6

Author(s):

Laima Alam

Keyword(s):

Hepatocellular Carcinoma ◽

Cross Sectional Study ◽

Treatment Modalities ◽

Fisher Exact Test ◽

Tumour Staging ◽

Chi Square ◽

Cross Sectional ◽

Exact Test ◽

Team Meetings ◽

Contrast Enhanced Ct

Objectives:Relation of demographics of hepatocellular-carcinoma with the aetiology.Tumour characteristics in relation to anti-viral therapy and presence of viral-DNA/RNATreatment modalities offeredMethods: This cross-sectional study enrolled all the patients aged 18-70 years with diagnosed hepatocellular carcinoma either through Triphasic Contrast-Enhanced-CT scan and/or Magnetic Resonance Imaging or biopsy presenting to the Outpatient-Department or multi-disciplinary-team meetings for the year 2019. Demographic variables, biochemical analysis including liver profile and stage of cirrhosis, viral-status, tumour staging and the treatment modalities offered were all noted. ANOVA (normal) and Kruskal-Wallis (non-normal) tests were used to compare quantitative data whereas chi-square-test and fisher-exact-test were used to compare qualitative-data.Results: Out of 195 patients with hepatocellular carcinoma, 76% were males in their fifth to sixth decades of life, 96% had cirrhosis, 94% corresponded to viral hepatocellular-carcinoma (82% Hepatitis-C-Virus, 9% Hepatitis-B-Virus and 3% coinfection), 60% of the cirrhotics landed in Child-Pugh A category with tumour staging BCLC-B being the predominant one (43.6%) and single and multiple bilateral nodules were the commonest lesions encountered. Platelets and Alanine-Transaminase had a significant relation across aetiological groups. Lymph-nodes were the most common extra-hepatic organs for metastasis and the presence of viral PCR had a significant impact on the tumour aggressiveness. Thirty-two percent of the patients were amenable to curative treatment.Conclusion: Viral infection is the main cause of rising prevalence of this tumour in Pakistan. Treatment modalities are expensive and expertise are lacking. A nationwide cancer registry is required for the exact disease burden and tumour behaviour for our population. Continuous....

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Use of intravenous alprostadil in patients with severe critical ischemia of the lower limbs

Vascular ◽

10.1177/1708538118816267 ◽

2018 ◽

Vol 27 (3) ◽

pp. 318-323

Author(s):

Jorge Enrique Machado-Alba ◽

Manuel E Machado-Duque

Keyword(s):

Critical Limb Ischemia ◽

Adverse Reactions ◽

Limb Ischemia ◽

Cross Sectional Study ◽

Lower Limbs ◽

Critical Ischemia ◽

Cross Sectional ◽

Potential Benefits ◽

Advanced Stages ◽

Clinical Records

Objectives To determine the indications for the use, potential benefits, and adverse reactions of alprostadil in a group of Colombian patients. Methods A retrospective cross-sectional study was conducted in patients diagnosed with critical limb ischemia who received alprostadil in five hospitals in Colombia between September 2011 and July 2017. We reviewed the clinical records of each patient to obtain the sociodemographic and pharmacological variables, clinical stages, complications, comorbidities, reported effectiveness and adverse reactions. Results Sixty-one patients treated with alprostadil were evaluated; 50.8% of patients were men, and the average age of 72.5 ± 10.7 years. A total of 86.9% of patients were hypertensive, and 65.6% were diabetic. A total of 77.0% presented ulceration, and this condition was considered as a diabetic foot in 57.4% of patients. A total of 81.9% of patients were classified as Fontaine stage 4; 60.7% received therapy as initially indicated, with an average of 19 days of alprostadil use. Regarding the therapy results, 58.0% of the patients with ulcers or trophic lesions showed improvement, 86.2% showed improvement of pain, and the limb was saved in 72.1% of patients. Conclusions Critical limb ischemia was presented by patients with advanced age and high cardiovascular risk who were treated during severe and advanced stages where therapeutic options are limited. Treatment with alprostadil achieved satisfactory results with improvement in ulcers, pain, and limb salvage rates in this series of patients.

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Prevalence of biologic, behavioral and psychosocial determinant of tuberculosis in tuberculosis patients of Semnan city; a five-year cross-sectional study

Journal of Preventive Epidemiology ◽

10.34172/jpe.2020.24 ◽

2020 ◽

Vol 5 (2) ◽

pp. e24-e24

Author(s):

Naim Sadat Kia ◽

Mohammad Nassaji Zavareh ◽

Elnaz Sarkheil ◽

Elaheh Ghods

Keyword(s):

Demographic Data ◽

Cross Sectional Study ◽

Alcoholic Beverages ◽

Cross Sectional ◽

Factors Affecting ◽

Incidence And Mortality ◽

The Social ◽

Household Crowding ◽

Clinical Records ◽

The Impact

Introduction: Tuberculosis (TB) is one of the most common and lethal infectious diseases. Objectives: Due to the impact of biological, behavioral, socio-economic factors on the incidence of TB and the risks of the disease, we aimed to investigate the factors affecting TB in TB patients in Semnan. Patients and Methods: All patients with confirmed TB, who were referred to primary healthcare centers in Semnan for receiving medication, enrolled in the study (2012 to 2016). Data collected from clinical records and in-person interviews. The questionnaire consisted of two parts; the first part was demographic data and the other was related to the risk factors for TB. Results: The household crowding index was 1.86 ± 0.88. Most of patients (48.1%) were elderly (≥60 years old), female (59.7%), housewife (48.1%), had a pre-diploma education (63.6%), low-monthly income (62.3%) and married (63.6%). Around13.0% had diabetes. 20.8% drug abuser, 16.9% cigarettes and tobacco smokers, and 1.3% consumed alcoholic beverages. Besides, 40.3% were Afghans and 1.3% had the Pakistani nation. Conclusion: Identifying and controlling the social, geographical and biological factors affecting the incidence and mortality of TB in different regions can help to formulate appropriate strategies for achieving global goals. These factors differ among native and non-native population.

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