Universidad Peruana Cayetano Heredia

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

Mostrar el registro sencillo del ítem

dc.contributor.author Solis-Pazmino, Paola
dc.contributor.author Salazar-Vega, Jorge
dc.contributor.author Lincango-Naranjo, Eddy
dc.contributor.author Garcia, Cristhian
dc.contributor.author Jaramillo Koupermann, Gabriela
dc.contributor.author Ortiz-Prado, Esteban
dc.contributor.author Ledesma, Tannya
dc.contributor.author Rojas, Tatiana
dc.contributor.author Alvarado-Mafla, Benjamin
dc.contributor.author Cárcamo Cavagnaro, César Paul Eugenio
dc.contributor.author Ponce, Oscar J.
dc.contributor.author Brito, Juan P.
dc.date.accessioned 2021-04-13T20:50:57Z
dc.date.available 2021-04-13T20:50:57Z
dc.date.issued 2021
dc.identifier.uri https://hdl.handle.net/20.500.12866/9105
dc.description.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. en_US
dc.language.iso eng
dc.publisher BioMed Central
dc.relation.ispartofseries BMC Cancer
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject adult en_US
dc.subject aged en_US
dc.subject Article en_US
dc.subject controlled study en_US
dc.subject female en_US
dc.subject human en_US
dc.subject major clinical study en_US
dc.subject male en_US
dc.subject cross-sectional study en_US
dc.subject postoperative complication en_US
dc.subject very elderly en_US
dc.subject young adult en_US
dc.subject anaplastic carcinoma en_US
dc.subject antibody blood level en_US
dc.subject cancer incidence en_US
dc.subject cancer mortality en_US
dc.subject diagnostic error en_US
dc.subject echography en_US
dc.subject Ecuador en_US
dc.subject family history en_US
dc.subject fine needle aspiration biopsy en_US
dc.subject high risk patient en_US
dc.subject histology en_US
dc.subject histopathology en_US
dc.subject Histopathology en_US
dc.subject human tissue en_US
dc.subject hypocalcemia en_US
dc.subject hypoparathyroidism en_US
dc.subject incidental finding en_US
dc.subject intermediate risk patient en_US
dc.subject Latin-America en_US
dc.subject low risk patient en_US
dc.subject lymph node metastasis en_US
dc.subject mortality risk en_US
dc.subject neck dissection en_US
dc.subject nerve injury en_US
dc.subject Outcome en_US
dc.subject radioactive iodine en_US
dc.subject recurrence risk en_US
dc.subject recurrent laryngeal nerve injury en_US
dc.subject spinal nerve en_US
dc.subject spinal nerve injury en_US
dc.subject Surgical en_US
dc.subject therapeutic error en_US
dc.subject thyroglobulin en_US
dc.subject thyroglobulin antibody en_US
dc.subject thyroglobulin blood level en_US
dc.subject thyroid cancer en_US
dc.subject Thyroid Cancer en_US
dc.subject thyroid follicular carcinoma en_US
dc.subject thyroid medullary carcinoma en_US
dc.subject thyroid papillary carcinoma en_US
dc.subject thyroidectomy en_US
dc.subject thyrotropin en_US
dc.subject thyrotropin blood level en_US
dc.subject treatment outcome en_US
dc.subject tumor volume en_US
dc.title Thyroid cancer overdiagnosis and overtreatment: a cross- sectional study at a thyroid cancer referral center in Ecuador en_US
dc.type info:eu-repo/semantics/review
dc.identifier.doi https://doi.org/10.1186/s12885-020-07735-y
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.21
dc.relation.issn 1471-2407


Ficheros en el ítem

Ficheros Tamaño Formato Ver

No hay ficheros asociados a este ítem.

Este ítem aparece en la(s) siguiente(s) colección(ones)

Mostrar el registro sencillo del ítem

info:eu-repo/semantics/restrictedAccess Excepto si se señala otra cosa, la licencia del ítem se describe como info:eu-repo/semantics/restrictedAccess

Buscar en el Repositorio


Listar

Panel de Control

Estadísticas