Results
The median age of the cohort was 47 years (range 17-87y). Of the
patients, 20 were male and 42 female, approximately the 1:2 ratio
typical of DTC populations in Scotland (2). Only one patient (2%) died
and one patient (2%) did not undergo surgery but was managed with
palliative radiotherapy.
Of the 62 non-incidental patients, 47 (76%) had papillary carcinoma, 12
(19%) had follicular carcinoma, two (3%) had foci of anaplastic
carcinoma and one (2%) had areas of both papillary and follicular
carcinoma.
In terms of waiting times for diagnosis and management, there was no
significant difference between patients referred by General
Practitioners (GP) on the ‘urgent suspicion of cancer’ pathway (median
114d and 111d) and those referred routinely (median 135d (P=0.39)) and
133d (p=0.26)), or under the urgent, non-cancer referral pathway (median
133d (p=0.37) and 181d (P=0.27)) (Table 1). Despite this, there was a
trend for more rapid management of urgent referrals.
All patients underwent pre-treatment fine needle aspiration or core
needle biopsy. Within the cohort, patients were grouped according to
whether they had a suspicious (Thy4) or diagnostic FNA (Thy5) [Group
1] (35 patients, 56%), or a non-diagnostic (Thy1), benign (Thy2) or
indeterminate (Thy3a/Thy3f) FNA [Group 2] (27 patients, 44%).
Patients in Group 1 were diagnosed more expeditiously than those in
Group 2 (129d (1-463) vs 204d (65-777), p<0.0005). The time
from referral to treatment of the patients in Group 1 (127d (47-442))
was also quicker than that of the patients in Group 2 (182d (54-754),
p=0.022).
Within these groups, there were significant (p=<0.0005)
differences in tumour characteristics (Table 3). Most notably, there was
an increased proportion of papillary cancers, N1 and M1 disease in Group
2 compared with Group 1 (Table 2). There was no significant difference
in age between the 2 cohorts (p=0.31).
With a median follow up of 33 months, only one patient has died to date.