Treatment of differentiated thyroid carcinoma. Experience in SOLCA Guayaquil

The paper presents a group of 138 patients with differentiated thyroid carcinoma treated at Solca, Guayaquil during 1994-2000. Among the group predominated the papilar histological type (n=110,79.7%), follicular (n=11,8.0%) or papilar/follicular (n=13,9.4%). Aspirative fine needle biopsy was performed in 56/138 patients (40.6%), with positive finding of malignant cells in 29/56 (56.8%), negative in 14/56 (25%) and not conclusive in 13/56 (23.2%). Near total thyroidectomy was performed in 83/138 patients and partial thyroidectomy (lobar and isthmus resection) was done in 47/138. In 33 patients there was performed additionally cervical lymphadenectomy. All patients were send to radioiodine ablation 4-8 weeks after surgery. At the moment of the treatment with 131I-Na all patients were classified according to the prognostic factors for risk of metastases, recidives or death in; high risk (n=72), intermediate risk (n=38) and low risk (n=28). All patients received one 131I-Na dose (n=117), or two or more doses of radioiodine (n=21), with total cumulative 131I-Na dose of <100 mCi (n=7), 100 mCi (n=98), 100-200 mCi (n=14) or >200 mCi (n=18). The follow-up time for the group was 2-6 years (n=86), but with follow-up of <2 years (n=15) or >6 years (n=23). At the moment of the last medical control there was 112/138 patients alive without signs of tumor activity, 20/130 alives but with persistence of tumor activity, and 6/138 death. (The author)