Clinico-pathological Characteristics and Survival Analysis of 300 Thyroid Cancer Cases in One Referral Hospital in Kelantan, Malaysia: A 10-year study

Abstract

Introduction: Thyroid cancer is ranked fourth in a state of Kelantan, while ranked much lower in other states in Malaysia. We determined the clinicopathological characteristics and the survival analysis of each thyroid cancer type seen in Hospital Universiti Sains Malaysia (HUSM), a referral hospital in the East Coast region of West Malaysia. Methods: Registry of patients diagnosed with thyroid cancer from years 2006 to 2015 was obtained from the medical record office of HUSM. Close scrutiny of the registry was carried out manually to ensure no duplicate entry. The data obtained were age, gender, histological diagnoses and dates of clinical follow-ups. The data were analyzed using IBM SPSS statistics version 24 for Windows. Survival analyses were carried out using Kaplan Meier approach. Results: A total of 300 patients with thyroid cancer were recorded in this 10 year period. The average rise of cancer per year was 27.2%. The most common tumor type was papillary; 230(76.7%) followed by 58(19.3%) follicular, 10(3.3%) anaplastic and 2(0.7%) medullary carcinomas. Female to male ratio was 4.1:1 (p=000). All anaplastic carcinoma cases were women. The age ranged from 11 years to 86 years with the mean age for women at 49.78 years (SD15.17) and for men at 53.27 years (SD14.45). The peak age for papillary carcinoma was in the 5th decade. The 5-year survival of papillary was 94%, follicular 88% and anaplastic 30% and the two medullary carcinoma cases are still alive after 5 years. In general, women had higher survival than men for papillary and follicular carcinoma. Those below 40 years old had the better prognosis compared to older patients.Conclusion: The frequency of thyroid cancer in Kelantan is increasing over the years. The peak age of the patients is older than those thyroid cancers associated with radiation exposure. The 5-year survival for all cancers is comparable with other countries.