OBJECTIVETo study the changes in the constituent ratio of patients received surgical therapy for their thyroid diseases in Peking Union Medical College Hospital from 1986 to 2012.

METHODSThe clinical data of patients received surgical therapy with pathologically confirmed findings from 1986 to 2012 were collected, and a corresponding database was established. The constituent ratios of thyroid diseases and thyroid malignant tumor among different population groups in different years were analyzed.

RESULTSThe number of patients with thyroid diseases admitted to our hospital had significantly increased in the past 27 years, particularly those with nodular goiter or thyroid cancer. The composition ratios of thyroid cancer and nodular goiter increased significantly, and among malignancies the papillary thyroid carcinoma increased obviously. The detection rate of papillary thyroid micro-carcinoma had continuously increased since 2008.

CONCLUSIONThyroid diseases and malignant tumor pathological types had dramatically changed in hospitalized patients in our hospital in the past 27 years.

Adult ; Female ; Goiter, Nodular ; epidemiology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Diseases ; epidemiology ; surgery ; Thyroid Neoplasms ; epidemiology ; pathology

OBJECTIVETo compare the total thyroidectomy or subtotal resection and gland lobe and isthmus lobectomy as initial treatment to TNM stage I and II differentiated thyroid cancer. The difference between recurrence rate and surgical complications were analysed.

METHODSThe literatures published between 1972-2012 were searched in Pubmed, Medline, Wanfang database, Chinese Biomedical Literature Database, Chinese scientific Journals database and China National Knowledge Infrastructure. According to the inclusion and deletion criteria, 17 articles were included to compare the postoperative recurrence and complications in randomized controlled or case-control studies, involving 13 articles in recurrence rate and 11 articles in complications.RevMan5.0 software package was used to perform meta-analysis.

RESULTSThirteen articles involved with the recurrence rate, the total case number was 3511. Among these cases, 414 recurred, overall recurrence rate was 11.59%, of which, 150 recurred cases in total or subtotal resection group (experimental group), the recurrence rate was 6.51%; 264 recurred cases in gland lobe lobectomy plus isthmus group (control group), the recurrence rate was 21.83%. Comparing the two groups, the odds ratio (OR) and their 95% confidence interval (95%CI) was 0.26 [0.21,0.33], Z value was 11.33, P < 0.01, which showed that the recurrence rate in experimental group was significantly lower than that in control group.Eleven articles involved with the complications, the total case number was 2388, 166 cases had postoperative complications. The complication rate was 6.95%, of which, 109 cases in experimental group, the complication rate was 8.52%; 57 cases in control group, the complication rate was 5.15%. Compared with the two groups, OR values and their 95%CI was 3.63 [2.47, 5.33], Z was 6.58, P < 0.01, the experimental group had significantly higher incidence of complications.

CONCLUSIONFor I and II differentiated thyroid cancer, total thyroidectomy or subtotal resection may reduce the chance of recurrence, but the postoperative complications is higher; while gland lobe and isthmus lobectomy has lower postoperative complications, but may increase the risk of relapse.

Humans ; Neoplasm Recurrence, Local ; epidemiology ; Postoperative Complications ; epidemiology ; Thyroid Neoplasms ; pathology ; surgery ; Thyroidectomy ; adverse effects ; methods

In order to determine the incidence and to understand recent trend of thyroid neoplasm and other thyroid diseases among Korean, a nation-wide collection of biopsy-confirmed and surgically removed thyroid lesions from 30 pathology laboratories of university and general hospitals was made over a 3-year-period from 1986 to 1988. These tumors and tumor-like lesions of the thyroid were classified according to the WHO classification. Results of this study were compared with those of the previous in Korea and other countries. Among the 7758 collected cases from 7449 patients, adenomatous goiter was the most common, comprising 2681 cases (34.6%), followed by follicular adenoma, 1868 cases (24.1%) and papillary carcinoma, 1474 cases (19%). Neoplastic condition comprised 48.8% (3786 cases). Of malignant tumors, papillary carcinoma was the most frequent accounting for 79.8%. The female to male ratio was 7.5:1 with female predominance. This female predominance was noted in all but two thyroid diseases. Medullary carcinoma showed equal distribution in both sexes, and two cases of malignant lymphoma developed in males. Thyroid diseases were common at the 3rd to 6th decades with peak incidence at the 4th decade. The right lobe of the thyroid was more frequently involved than the left lobe (1.6:1). The diagnoses were made largely on the surgically excised specimen (85.3%). Multiplicity of the lesions revealed single lesion in 64%, multiple and diffuse lesion in 36% of cases investigated. Average size of the lesion was in the range of 1-5 cm in diameter (62%).
Adenoma/diagnosis/*epidemiology/pathology ; Adolescent ; Adult ; Biopsy ; Carcinoma/diagnosis/*epidemiology/pathology ; Child ; Child, Preschool ; Female ; Humans ; Incidence ; Infant ; Infant, Newborn ; Korea/epidemiology ; Lymphoma/diagnosis/*epidemiology/pathology ; Male ; Middle Aged ; Thyroid Diseases/*epidemiology ; Thyroid Neoplasms/diagnosis/*epidemiology/pathology ; World Health Organization

OBJECTIVETo investigate and analyze the variation trends in the pathological composition of thyroid cancer patients treated in Tianjin Cancer Hospital from 1954 to 2009.

METHODSTo retrospectively analyze the incidence and clinical features of different pathological types of thyroid cancers in 4342 patients between different time periods from 1954 to 2009.

RESULTSIn the four main pathological types of thyroid cancers, the component ratio of papillary thyroid cancer in every period was 68.1%, 78.3%, 81.3%, 82.1%, 85.8%, respectively, while the morbidity of patients with papillary thyroid carcinoma concurrent with Hashimoto's thyroiditis was increased, so was the proportion of tumors in diameter < or = 2 cm. The proportion of follicular thyroid carcinoma and anaplastic thyroid carcinoma was decreasing accordingly; however, the proportion of medullary thyroid carcinoma did not change significantly.

CONCLUSIONSThe pathological classification of the thyroid carcinoma patients has significant changes in the 4342 cases treated in our Hospital from 1954 to 2009. The proportion of papillary carcinoma is increased, while that of follicular carcinoma and anaplastic carcinoma is decreased. The reasons might attribute to the improved level of consultations and iodized diet or other factors.

Adenocarcinoma, Follicular ; epidemiology ; pathology ; Carcinoma ; epidemiology ; pathology ; Carcinoma, Medullary ; epidemiology ; pathology ; Carcinoma, Papillary ; epidemiology ; pathology ; China ; epidemiology ; Female ; Hashimoto Disease ; complications ; epidemiology ; pathology ; Humans ; Incidence ; Male ; Retrospective Studies ; Thyroid Neoplasms ; complications ; epidemiology ; pathology ; Tumor Burden

The medical records of inpatients with diagnoses of either ICD-9 193(malignant neoplasm of the thyroid gland) or 226(benign neoplasm of the thyroid gland) in the claims sent in by medical care institutions throughout the country, to the Korea Medical Insurance Corporation (KMIC) during the period from January 1, 1986 to December 31, 1987 were abstracted. These records were abstracted in order to identify and confirm new cases of thyroid cancer among the beneficiaries of the KMIC. Using these data, the incidence rate of thyroid cancer among Koreans was estimated as of July 1, 1986 through June 30, 1987. The crude rates were estimated to be 0.76(95% Cl: 0.63-0.87) and 3.87(95% Cl: 3.60-4.14) per 100,000 in males and females, respectively, and the cumulative rates for the age spans 0-64 and 0-74 in males were 0.06% and 1.10%, respectively. In females, those were equally 0.35%. The age-adjusted rate for the world population was 0.93 per 100,000 in males, which is one of the lowest levels in the world. However, the adjusted rate in females was 3.96 per 100,000, which is an average level and very similar to that of the Chinese in Singapore and Shanghai. A similar tendency was shown in the case of the truncated rates for the age group of 35-64, which was 1.91 per 100,000 in males and 8.82 per 100,000 in females.
Adolescent ; Adult ; Age Factors ; Aged ; Epidemiologic Factors ; Female ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Sex Factors ; Thyroid Neoplasms/*epidemiology/pathology

PURPOSE: To assess the incidence of thyroid malignancy in an adult population screened by high-resolution ultrasonography at a medical screening center and to compare the clinical and pathological features of screen-detected thyroid carcinomas to symptomatic overt thyroid carcinomas. MATERIALS AND METHODS: We calculated the prevalence of screen-detected thyroid cancer at a medical screening center using high- resolution ultrasonography and fine needle aspiration. We then compared the clinical and pathological features of screen-detected thyroid cancers (n = 46) to clinical symptomatic thyroid cancers (n = 157). We evaluated age, gender, size, perithyroidal extension, lymphovascular extension, stage, histological lymph node metastasis, and the type of cancer. We also compared the above findings of micropapillary carcinomas to papillary thyroid carcinomas that were larger than 1cm in diameter. RESULTS: Screen-detected thyroid nodule patients were 2,747 (37%) of 7,491 patients. Nodules selected for fine needle aspiration were 658 and cytology confirmed malignancy were 79 (12%) nodules. When screen-detected thyroid cancers (n = 46) were compared to symptomatic overt thyroid cancers (n = 157), only statistically significant factor was size (p = 0.002). Papillary thyroid carcinomas that were larger than 1 cm had more frequent capsular invasion (p = 0.000) and a higher stage (p = 0.027), and a higher prevalence of lymph node metastases (p = 0.002). CONCLUSION: Screen-detected thyroid cancers should be managed as same as symptomatic thyroid cancers in respect to size, and an assessment should strictly be based on the ultrasound features and fine needle aspiration biopsy findings.
Adult ; Age Factors ; Biopsy, Fine-Needle ; Carcinoma, Papillary/*epidemiology/pathology/ultrasonography ; Female ; Humans ; Korea/epidemiology ; Male ; Mass Screening ; Middle Aged ; Prevalence ; Sex Factors ; Thyroid Neoplasms/*epidemiology/pathology/ultrasonography

OBJECTIVETo investigate the association between serum TSH concentration and thyroid cancer incidence.

METHODSThree hundred and thirty patients with thyroid tumors who underwent surgical treatment were included in this study (99 cases of malignancy and 231 cases of benign tumors). The data of their serum TSH level, gender, age, tumor type, and number of tumors detected by ultrasonic inspection were retrospectively analyzed, and their association with thyroid cancer incidence was explored.

RESULTSThe proportion of thyroid cancer in the groups of younger than twenty years and older than seventy years were 63.0% and 58.3%, respectively, significantly higher than that in the group of age between 60 and 69 years (23.3%, P < 0.05). The incidence of thyroid cancer of the 81 male patients was 43.2%, significantly higher than that in the 249 female patients (25.7%, P = 0.003). The incidence of thyroid cancer in the 112 patients with single nodule was 42.0%, significantly higher than that in the 218 patients with multiple nodules (23.9%, P < 0.001). In the groups with TSH level lower than 0.28 mIU/L and higher than 4.20 mIU/L, the incidence of thyroid cancer were 54.6% and 50.0%, respectively, significantly higher than that in the group with TSH level between 0.28 and 1.44 mIU/L (16.1%, P < 0.05). The proportion of patients with thyroid cancer was also increased with the increasing serum TSH level in the normal range (P < 0.001). High serum TSH level (OR = 1.465, P = 0.014), male (OR = 1.964, P = 0.016) and a single thyroid nodule (OR = 2.090, P = 0.006) are independent risk factors of thyroid cancer.

CONCLUSIONThe high serum TSH level, male, single thyroid nodule are factors leading to a high incidence of thyroid cancer.

Adenoma ; blood ; pathology ; Adult ; Age Factors ; Aged ; Carcinoma ; blood ; epidemiology ; pathology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Sex Factors ; Thyroid Neoplasms ; blood ; epidemiology ; pathology ; Thyroid Nodule ; blood ; pathology ; Thyrotropin ; blood ; Young Adult

PURPOSE: Decision to perform concurrent ipsilateral thyroidectomy on patients with hypopharyngeal cancer is important, and unnecessary thyroidectomy should be avoided if oncologically feasible. We hypothesized that concurrent ipsilateral thyroidectomy is not routinely required to prevent occult metastasis. This study aimed to determine the prevalence of histological thyroid invasion in patients with hypopharyngeal cancer, and to refine the indications for prophylactic ipsilateral thyroidectomy in patients with hypopharyngeal cancer. MATERIALS AND METHODS: A retrospective review of the medical records from the Department of Otolaryngology at Yonsei University College of Medicine was conducted from January 1994 to December 2009. A total of 49 patients underwent laryngopharyngectomy with thyroidectomy as a primary treatment of hypopharyngeal cancer. RESULTS: The incidence of thyroid gland involvement was 10.2%. The most common route of invasion was direct extension through the thyroid cartilage. Thyroid cartilage invasion (p=0.034) was the most significant factor associated with thyroid invasion. Disease-specific survival at 5 years was lower in patients with than without thyroid gland invasion (26.7% vs. 55.2%, respectively; p=0.032). Disease-free survival at 5 years was also lower in patients with than without thyroid gland invasion (20.0% vs. 52.1%, respectively; p=0.024). CONCLUSION: Ipsilateral thyroidectomy in combination with total laryngopharyngectomy is indicated when invasion of the thyroid cartilage is suspected in patients with hypopharyngeal cancer.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell/epidemiology/pathology/*surgery ; Disease-Free Survival ; Female ; Humans ; Hypopharyngeal Neoplasms/epidemiology/pathology/*surgery ; Incidence ; *Laryngectomy ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasms, Second Primary/epidemiology/pathology/surgery ; *Pharyngectomy ; Predictive Value of Tests ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; Thyroid Gland/*pathology/surgery ; Thyroid Neoplasms/epidemiology/*secondary ; Thyroidectomy/*methods

Oncologists and scientists in the field of head and neck cancer exchanged their research findings and clinical experiences in the Sino-USA Symposium on Head and Neck Cancer, which was held January 6-7, 2012 in Guangzhou, China. The symposium was jointly organized by Sun Yat-sen University Cancer Center (SYSUCC) and the University of Texas MD Anderson Cancer Center (MDACC). The Guangdong Provincial Anti-Cancer Association and the Chinese Journal of Cancer also helped in organizing the conference. Speakers were from China (SYSUCC, the Chinese University of Hong Kong, Tianjin Medical University Cancer Institute and Hospital, and Fudan University Shanghai Cancer Center) and the United States (MDACC). The presentations covered most kinds of head and neck cancers and included both basic and clinical research progress. In particular, NPC was discussed in depth. The symposium explored the reality that cancer is complex and numerous questions remain to be answered, even though there has already been an enormous effort into research. International exchanges of experience and in-depth cooperation are definitely needed to improve our capability of caring for cancer patients. In this article, we provide highlights of the presentations.
Carcinoma, Squamous Cell ; genetics ; Combined Modality Therapy ; Drug Delivery Systems ; Head and Neck Neoplasms ; drug therapy ; etiology ; genetics ; pathology ; surgery ; Humans ; Nasopharyngeal Neoplasms ; genetics ; pathology ; therapy ; Thyroid Neoplasms ; epidemiology

Histologic patterns at tumor margins may be related to prognosis in several malignancies. We investigated tumor aggressiveness with respect to tumor margin histology in patients with papillary thyroid carcinoma (PTC). Five hundred fourteen consecutive patients who underwent surgery for primary PTC between January and July 2009 were assigned to two groups, one with an infiltrative pattern (I-type, n = 347) at tumor margins and one with an expanding pattern (E-type, n = 167). Tumor aggressiveness was assessed by analyzing relationships between these patterns and known prognostic factors. The analysis showed that unfavorable prognostic factors such as tumor multiplicity (P = 0.002), extrathyroidal extension (P < 0.001), lateral neck lymph node metastasis (P < 0.001) and advanced TNM stage (P = 0.001) were significantly more prevalent in patients with I-type PTC than in those with the E-type. Central neck node metastases were more prevalent without statistical significance in the I-type patients (P = 0.376). Tumor margin histology was not related to gender or tumor size. These results suggest that histologic patterns at tumor margins predict aggressiveness in PTC.
Adult ; Cell Proliferation ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Prognosis ; Thyroid Neoplasms/epidemiology/*pathology