Defining the outcome of patients with delayed diagnosis of differentiated thyroid cancer

Laryngoscope. 2014 Dec;124(12):2837-40. doi: 10.1002/lary.24744. Epub 2014 May 27.

Abstract

Objectives/hypothesis: In the present study we sought to define the outcome of patients with delay in diagnosis and treatment (>1 year) of well-differentiated thyroid carcinoma (WDTC) due to initial benign cytology (IBC).

Study design: Retrospective medical record review and analysis of survival outcomes.

Methods: The records of 47 patients with delayed diagnosis of thyroid cancer were reviewed. In 38, surgery was performed for growing nodules and in nine due to malignant cytology during follow-up. Median time to delayed surgery was 52 months (range, 13-205 months). Multivariate analysis was performed to assess variables associated with outcome.

Results: Most patients (32/47) underwent total thyroidectomy, whereas 15/47 had hemithyroidectomy. With a median follow-up of 96 months (range, 12-184 months), the 5-year disease-free survival of these patients was 96%. Multivariate analysis showed that the outcome of these patients was not statistically different than that of patients (n = 162) who underwent immediate surgery for similar disease.

Conclusions: We show that patients with delayed diagnosis and treatment for WDTC due to IBC have excellent outcome.

Level of evidence: 4.

Keywords: Thyroid; delayed; fine-needle aspiration; observation; papillary; surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / mortality
  • Adenocarcinoma / surgery
  • Biopsy, Fine-Needle
  • Delayed Diagnosis*
  • Diagnosis, Differential
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Israel / epidemiology
  • Male
  • Middle Aged
  • Neoplasm Staging / methods*
  • Prognosis
  • Retrospective Studies
  • Survival Rate / trends
  • Thyroid Neoplasms / diagnosis*
  • Thyroid Neoplasms / mortality
  • Thyroid Neoplasms / surgery
  • Thyroidectomy
  • Time Factors