Thyroid cancer outcomes in Filipino patients.
OBJECTIVE
To compare the outcomes of patients having thyroid cancer among Filipinos vs non-Filipinos.


METHODS
Retrospective medical record review.


METHODS
High-volume tertiary referral center in Toronto, Ontario, Canada.


METHODS
A total of 499 patients with thyroid cancer (36 Filipino and 463 non-Filipino) treated at Mount Sinai Hospital from January 1, 1984, to August 31, 2003, with a minimum 5-year follow-up period and a minimum 1.0-cm tumor size. Patients were identified from a thyroid cancer database. Data on patient, tumor, and treatment factors were collected along with outcomes.


METHODS
The presence of thyroid cancer recurrence, the rate of death from disease, and the time to recurrence.


RESULTS
The 2 groups were similar for sex, age, history of head and neck radiation exposure, family history of thyroid cancer, follow-up time, tumor size, tumor pathologic findings, presence of tumor multifocality, stage of primary disease, type of thyroid surgery, use of postoperative radioactive iodine therapy, and use of external beam radiation therapy. Filipino patients experienced a thyroid cancer recurrence rate of 25% compared with 9.5% for non-Filipino patients (odds ratio, 3.20; 95% confidence interval, 1.23-7.49; P = .004). On multivariate analysis, the increased risk of thyroid cancer recurrence persisted for Filipino patients (odds ratio, 6.99; 95% confidence interval, 2.31-21.07; P < .001). No significant differences were noted between Filipino patients and non-Filipino patients regarding the rate of death from disease (5.6% vs 1.9%) and the time to recurrence (52.6 vs 53.1 months).


CONCLUSIONS
Filipino patients have a significantly higher risk of thyroid cancer recurrence compared with non-Filipino patients. However, no significant difference was noted in the time to recurrence or the rate of death from disease. These findings justify a more aggressive initial management and follow-up regimen for Filipino patients with thyroid cancer.
Kus
Lukas H
LH
Queen's University, Kingston, Canada.
Shah
Manish
M
Eski
Spiro
S
Walfish
Paul G
PG
Freeman
Jeremy L
JL
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000208:ethnology* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D010679:Philippines / Q000208:ethnology; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000208:ethnology* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult