Poster Presentation 

  

ABSTRACT ID
20231031
NAME
Asst. Prof. Keisuke Yamamoto
Type of Research
Original Research
Category
Epidemiology and Public Health
abAuthors
Keisuke Yamamoto#Sapporo medical University, Otolaryngology-Head and Neck Surgery#Yes#Makoto Kurose#Sapporo medical University, Otolaryngology-Head and Neck Surgery#No#Takeshi Iwaku#Sapporo Thyroid Clinic#No#Shin Takayanagi#Sapporo medical University, Otolaryngology-Head and Neck Surgery#No#Akito Kakiuchi#Sapporo medical University, Otolaryngology-Head and Neck Surgery#No#Kazufumi Obata#Sapporo medical University, Otolaryngology-Head and Neck Surgery#No#Kenichi Takano#Sapporo medical University, Otolaryngology-Head and Neck Surgery#No
Title
Clinical Characteristics of Coexisting Thyroid Cancer in Patients with Graves’ Disease
Abstract

Objectives
Reported rates of thyroid cancer in Graves' disease (GD) vary widely. The association between Graves' disease and co-existing thyroid cancer is still controversial, with most previous reports based on surgically treated GD patients. This study aims to investigate the clinicopathologic differences in GD patients who underwent surgical treatment based on the presence or absence of papillary thyroid carcinoma (PTC), as well as to determine the incidence and characteristics of incidental PTC.

Methods
We retrospectively analyzed data from 70 GD patients who underwent thyroidectomy at Sapporo Medical University Hospital between 2017 and 2024 were retrospectively collected and analyzed. Clinicodemographic factors, preoperative characteristics, surgical details, final histopathologic findings, and postoperative courses were collected based on the presence or absence of thyroid cancer. The prevalence of incidental PTC and preoperatively suspected PTC was analyzed and compared according to cancer status.

Results
Seventy patients were included in the study, with a mean age of 42 (±14) years, a female proportion of 52%, and a mean body mass index (BMI) of 23 kg/m². Malignancy was identified in 12 of 70 (17%) GD patients; 5 of 12 (42%) were incidental carcinomas. Compared to patients without PTC, patients with PTC had a significantly lower incidence of surgery for a large mass (p=0.004), a higher frequency of tumor comorbidity (p<0.001), a lower proportion of elevated TRAb levels (p<0.001), smaller thyroid diameters (p=0.001), shorter operative times (p=0.006), less blood loss (p=0.019), and a higher rate of preoperative nodule detection (p<0.001). No significant differences in tumor characteristics were observed between incidental and pre-diagnosed PTC cases.

Conclusions

The high prevalence of concomitant thyroid cancer in GD patients underscores the importance of careful preoperative ultrasound screening to guide appropriate therapeutic management. Further research is needed to elucidate the clinical significance of incidental PTC in GD patients.
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