title: Epidemiology and survival of patients with well-differentiated thyroid cancer subjected to total thyroidectomy in Thrace area, Northern Greece: a 20-year experience.
abstract: OBJECTIVE
  The aim of this study was to evaluate epidemiology and survival of patients with well-differentiated thyroid cancer (WTC) treated with total thyroidectomy (TT) in the area of Thrace, Northern Greece.
  
  
  METHODS
  The study was conducted on 80 patients who underwent total thyroidectomy from January 1985 to December 2004 for WTC. Patients' medical records and demographics, including age, sex, histological type (papillary, follicular, mixed type papillary-follicular, Hurthle), stage according to TNM staging, coexistence or future postoperative occurrence of local recurrence or distal metastases and overall and specific survival were analyzed and survival rates were calculated.
  
  
  RESULTS
  Papillary carcinoma was found in 56.3% and follicular in 43.8%. Statistical analysis revealed significant correlation of male gender with the high-risk population (P = 0.017), follicular carcinoma with high-risk population (P < 0.0001) and high-risk population with local recurrence or metastatic disease (P < 0.0001). Overall year, 5-year and 10-year survival were 100%, 94% and 91.8% respectively. Further analysis showed a significant reduction in survival regarding to age > 45 years (P = 0.03), follicular type (P = 0.009), high-risk population (P = 0.008), presence of local recurrence or metastatic disease (P < 0.0001) and not significant correlation with male gender (P = 0.086).
  
  
  CONCLUSIONS
  In conclusion, total thyroidectomy should be the surgical treatment of choice in all cases with WTC, especially in male patients > 45 years of age since they have a higher frequency of advanced malignant disease at presentation, a fact that affects prognosis. Patients must be accurately categorized postoperatively, and follow-up must be personalized, in order to diagnose recurrence as early as possible.
authors.affiliation: First Department of Surgery, University General Hospital of Alexandroupolis, Alexandroupolis, Greece. mikpapageo@yahoo.com
authors.forename: M S
authors.initials: MS
authors.lastname: Papageorgiou
authors.forename: N
authors.initials: N
authors.lastname: Liratzopoulos
authors.forename: M
authors.initials: M
authors.lastname: Karanikas
authors.forename: E I
authors.initials: EI
authors.lastname: Efremidou
authors.forename: G
authors.initials: G
authors.lastname: Minopoulos
authors.forename: K J
authors.initials: KJ
authors.lastname: Manolas
mesh_terms: D005260:Female; D006115:Greece; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery*; D013965:Thyroidectomy; D013997:Time Factors