Thyroid Cancer
Cancer of the thyroid
by Dr. Yea-ling Hsu
As of 2011, our new thyroid cancer patients accounted for 3.6% of all such patients nationwide.
Surgery is the primary treatment modality for cancer of the thyroid, and sometimes is followed by adjuvant radioactive treatment of 131 I (iodine). Different surgeries are performed – thyroid lobectomy, completion thyroidectomy, or near-total thyroidectomy, depending on the patient’s age and tumor characteristics. Sometimes removal of the enlarged lymph nodes from the neck may be done to test for cancer cells. The benefit of the subsequent adjuvant treatment of 131 I is both diagnostic and therapeutic. It is often used after thyroidectomy to destroy any remaining healthy thyroid tissue, as well as microscopic areas of thyroid cancer that weren't removed during surgery; it may also be used to treat local or distant recurrence of thyroid cancer after the treatment. It’s been reported the use of 131 I could lower the risks of relapse.
Our results
We did a retrospective study on our patients who had their initial diagnosis of and treatment for thyroid cancer in our hospital between 1990 and 2011 to assess the 5-year survival by disease staging (Table 1)
The patients of stages I, II, and III have achieved a 5-year survival rate of 95+%, and patients with stage IV disease, 70.4%.
Total patients: 996 M: 215 (21.6%) F: 781(78.4%) Median age: 43 (age 13-94)
5-year Thyroid Cancer Survival Rates by AJCC Staging (%)
|
Stage |
I |
II |
III |
IV |
Unclear |
Total |
|
# of patients |
541 |
154 |
159 |
76 |
66 |
996 |
|
% or patients |
54.3% |
15.5% |
16.0% |
7.6% |
6.6% |
|
|
5-year survival |
97.4% |
98.0% |
95.7% |
70.4% |
|
94.5% |
|
10-year survival |
95.4% |
95.4% |
93.7% |
55.9% |
|
90.7% |
Data source: KFSYSCC Annual Report 2011
Thyroid cancer survival by pathological type
5- and 10-year survival of thyroid cancer by pathological type 1990-2011 (n=996)
|
Pathological |
Papillary |
Follicular |
Poorly differentiated |
Others or unclear |
|
# of patients |
840 |
84 |
21 |
51 |
|
% of patients |
84.3% |
8.4% |
2.1% |
5.1% |
|
5-year survival |
96.3% |
93.5% |
53.4% |
|
|
10-year survival |
92.6% |
88.3% |
53.4% |
|
Data source: KFSYSCC Annual Report 2011
Comparison with data from other hospitals in Taiwan and in the U.S.
As of year-end 2012, our overall 5-year survival rate was 94.5%. Report from the Ministry of Health and Welfare showed a survival rate of 93.7% for female thyroid cancer patients (2002-2010) as opposed to our result of 95.9% for the same patient group from the same time period.
Comparison of overall survival data between KFSYSCC and the Ministry of Health and Welfare 2006-2010年（%）
|
|
KFSYSCC |
Island Wide |
||||
|
Survival |
All Patients |
Male |
Female |
Female |
||
|
|
1990-2011 |
2006-2010 |
2006-2010 |
2006-2010 |
2006-2010 |
|
|
1-year |
98.3 |
98.9 |
97.7 |
99.2 |
96.9 |
|
|
2-year |
96.8 |
97.1 |
95.5 |
97.5 |
95.8 |
|
|
3-year |
96.4 |
97.1 |
95.5 |
97.5 |
95.2 |
|
|
4-year |
95.8 |
97.1 |
95.5 |
97.5 |
94.4 |
|
|
5-year |
94.5 |
95.9 |
95.5 |
95.9 |
93.7 |
|
KFSYSCC Annual Report 2011（2013）
The data from the Surveillance Epidemiology and End Results(SEER) of the 5-year overall survival for thyroid cancer for the same period (2004 to 2010) showed a 95.6% survival rate for male patients and 98.5% for female while ours showed 88.7%and 96.2%, respectively.
Comparison of 5-year survival data with SEER 2004-2010（%）
|
|
KFSYSCC |
USA SEER# |
||||
|
|
All patients |
Male |
Female |
All patients |
Male |
Female |
|
Survival |
94.6 |
88.7 |
96.2 |
97.8 |
95.6 |
98.5 |
# SEER Cancer Statistics Review 2004-2010, relative survival rates
Relative survival is a net survival measure representing cancer survival in the absence of other causes of death, and, generally speaking, it is higher than the corresponding absolute survival by 1-3%.