Thyroid carcinoma
Of 567 patients diagnosed with thyroid carcinoma, two patients were
children. Separately, 45.31% of thyroid carcinomas diagnosed at autopsy
were found in patients between 50-and 70-years old Figure 1 .
Most patients in this group died between the age of 60 and 64 (15.34%).
There was a decrease in the incidence of thyroid cancer diagnosed at
autopsy between the years 2000 and 2017 (β = - 1.402, p=0.001). A
summary of thyroid cancer characteristics examined is shown inTable 1 . Of the cases reviewed, 87.79% of the cancers were
papillary carcinomas. Of the 277 thyroid carcinomas with documented
staging, 231 patients had stage 1, 13 patients had stage 2, 10 patients
had stage 3, and 25 patients had stage 4. The median tumor size was 7mm.
Of 271 patients with documented AJCC stages, the TMN staging, and their
frequencies were as follows: T1/T2 (91.14%), T3/T4 (8.86%); nodal
positivity (5.66%), and M1 (4.95%). Most patients (59.82%) had a
median household income between $50,000 and $75,000.
Thyroid carcinoma was the cause of death in 17 (3.01%) patients in this
group (8 papillary thyroid cancer, 3 follicular thyroid carcinoma, 1
anaplastic thyroid cancer, 1 medullary thyroid cancer, 1Hurthle cell
carcinoma, and 3 unspecified). Of the 17 patients with thyroid cancer
related deaths, 10 patients had specific AJCC staging: 3 (30.00%) had
stage 1 disease and 7 (70.00%) had stage 4 disease. The three most
common causes of deaths this cohort were heart disease (26.19%),
accident (9.20%), and infection (6.19%). There was no significant
difference between black and white patients (RR=2.60, 95%CI:
0.891-7.57, p=0.080). Patients over 70 years old were at lower risk of
thyroid-related deaths than those under 50 (RR=0.125, 95%CI:
0.016-1.001, p=0.025). There was no significant difference in
thyroid-related deaths in patients 50-70 years old and patients over 70
years old (RR=0.723, 95% CI: 0.275, 1.901, p=0.256). Thyroid
cancer-related deaths were more prevalent in females (RR=3.37, 95% CI:
1.095-9.59, p=0.033), in tumors larger than 4cm (RR=14.47, 95% CI:
3.155-66.36, p<0.001), and in stage 3 or 4 disease (RR=24.91,
95%CI: 5.39-115.0, p<0.0001) compared to males, tumors less
than 4cm, and stage 1 or 2 disease, respectively.
Patients with non-thyroid HNC were 17.1 (95%CI: 9.55-30.6,
p<0.001) times more likely to have cancer-related death found
at autopsy than thyroid carcinoma.