title: Evolution in the profile of thyroid cancer cases treated in an oncology reference service: what changed in the last 20 years.
abstract: OBJECTIVE
  To evaluate the characteristics of thyroid carcinoma cases treated at a reference hospital for cancer between 2008 and 2010.
  
  
  METHODS
  we studied 807 cases and analyzed the following clinicopathologic variables: symptoms, risk factors, diagnostic tests, staging, histological type, treatment performed and complications.
  
  
  RESULTS
  Females were more affected, with 660 cases (82%). The average age at diagnosis was 44.5 years. Prior exposure to ionizing radiation was reported by 22 (3%) patients, a family history of thyroid cancer by 89 (11%), and 289 (36%) individuals reported other types of cancer in the family. The fine needle aspiration biopsy was the main parameter for surgical indication and was suggestive of carcinoma in 463 patients (57%). Papillary carcinoma was the most common histological type, with 780 cases (96.6%). There were 728 (90%) total thyroidectomies, 43 (5.3%) reoperations or partial thyroidectomies followed by totalization, 23 (2.8%) extended thyroidectomies and only 13 (1.6%) partial thyroidectomies (lobectomy with isthmectomy). Neck dissection associated with thyroidectomy was done in 158 patients (19.5%). We observed a predominance of tumors classified as T1 in 602 (74.6%) patients. Transient hypocalcemia was the most frequent complication.
  
  
  CONCLUSIONS
  The results show that the worldwide increase in the incidence of thyroid cancer has changed the profile of patients seen at a referral service. In addition, there were changes in the type of surgical treatment used, with increased use of total thyroidectomy in relation to partial and subtotal ones, and decreased use of elective neck dissections.
authors.affiliation: Department of Head and Neck Surgery and Otorhinolaryngology, São Paulo, SP, Brazil.
authors.forename: Renan Bezerra
authors.initials: RB
authors.lastname: Lira
authors.affiliation: Department of Head and Neck Surgery and Otorhinolaryngology, São Paulo, SP, Brazil.
authors.forename: Genival Barbosa de
authors.initials: GB
authors.lastname: Carvalho
authors.affiliation: Department of Head and Neck Surgery and Otorhinolaryngology, São Paulo, SP, Brazil.
authors.forename: João
authors.initials: J
authors.lastname: Gonçalves Filho
authors.affiliation: Department of Head and Neck Surgery and Otorhinolaryngology, São Paulo, SP, Brazil.
authors.forename: Luiz Paulo
authors.initials: LP
authors.lastname: Kowalski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013965:Thyroidectomy; D013997:Time Factors; D055815:Young Adult