[Thyroid carcinoma. Retrospective analysis of case records of the III. Surgery Department at the Umberto I Clinics in Rome in the years 1990-93].
BACKGROUND
The aim of this investigation was to ascertain: 1) temporal trends in the incidence of thyroid carcinoma between 1990-1993; 2) regional differences in the incidence and histotype among the five provinces of Latium; 3) identification of risk factors, particularly of a preexisting thyroid tumour (goitre).


METHODS
Records of patients submitted to thyroid surgery at the Istitute of III Clinica Chirurgica dell'Università "La Sapienza" di Roma have been reviewed and a questionnaire filled-in.


RESULTS
In the period 1990-1993, 144 cases of thyroid carcinomas were operated; 77.7% of those resided in the Latium region. Average age was 43 +/- 16.2, F:M = 3:1. During the four years observation period there was an increase in all surgical interventions and proportionally increased also thyroid surgery (hyperplasia, thyroiditis, hyperthyroidism and thyroid cancer). Thyroid cancer was found in 10% of thyroid patients, this proportion remains constant in the period 1990-1992, in 1993 rising to 14% (p = 0.032). Differences of incidence although not significant were found in the five provinces of Latium. A higher proportion of follicular histotypes was found in the province of Frosinone (FR vs RM, 20 vs 13.5% p = 0.45). A previous goitre, standing for period of three or more years, was reported in the records of 25% of patients. Seven percent of patients have been previously submitted to a partial thyroidectomy for benign thyroid disease, most of those being operated for thyroid adenoma (8 out 10 cases).


CONCLUSIONS
During a four year period of observation an increase of thyroid carcinoma was observed only in 1993. This increase cannot be attributed to an increase in the incidence of thyroid carcinoma. The province of Frosinone, known to be an endemic area, shows a proportion of the follicular histotype higher than that of other provinces. Goiter precedes malignant thyroid neoplasia in a high proportion of patients (25%). Follicular adenoma found frequently at the histology of patients operated for benign thyroid disease suggesting a transformation from benign to a malignant condition.
Picchi
P
P
III Clinica Chirurgica, Policlinico Umberto I, Roma.
Salabè
G B
GB
Marzullo
A
A
Faloci
C
C
Campana
F P
FP
D018263:Adenocarcinoma, Follicular / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D000328:Adult; D002291:Carcinoma, Papillary / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D012384:Rome; D013959:Thyroid Diseases / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods; D013997:Time Factors