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The prognosis of patients with Graves’ disease found to have a small thyroid carcinoma at thyroidectomy is excellent
The
background of the study. Some patients with hyperthyroidism caused
by Graves’ disease who are treated by thyroidectomy are found at
surgery to have a thyroid carcinoma. In this study, the prognosis of patients
with Graves’ hyperthyroidism who had a small incidentally detected
thyroid carcinoma was compared with that of patients with other thyroid
disorders found to have an incidental carcinoma.
How the study was done. The study subjects were 509
patients with Graves’ hyperthyroidism and 509 age- and sex-matched
patients with other thyroid disorders (benign nodules, adenomas, thyroiditis)
who were found to have a 
1.0 cm carcinoma (microcarcinoma) at the
time of thyroidectomy. No additional treatment was given.
The results of the study. The types and size of the carcinoma in the two groups were similar, as was the frequency of multifocal tumors. In contrast, lymph-node metastases and invasion of adjacent tissue were more common in the non–Graves’ disease group.
The mean duration of follow-up was 13 years, during which 3 of the 509 patients with Graves’ disease (1 percent) had a recurrence of thyroid carcinoma, as compared with 17 (3 percent) of the non–Graves’ disease patients. The 20-year survival rate was 99 percent in the Graves’ disease patients and 93 percent in the non–Graves’ disease patients.
The conclusions of the study. Patients with Graves’ hyperthyroidism who are found to have a microcarcinoma at the time of thyroidectomy have an excellent prognosis.
The original article. Kikuchi S, Noguchi S, Yamashita H, Uchino S, Kawamoto H. Prognosis of small thyroid cancer in patients with Graves’ disease. Br J Surg 2006;93:434-9.
Next Article: The prognosis of patients
with diffuse sclerosing papillary carcinoma is poorer than that of
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| Thyroid Digest Index | | | July 2006 Thyroid Digest |
