What has changed in the last 20 years in post-operative spesmen findings of papillary thyroid cancer case? retrospective analysis

In this study, patients who were operated for papillary thyroid cancer (PTC) in the last 20-30 years; It is aimed to examine demographic characteristics, tumor size in specimen findings, number of foci, association with chronic lymphocytic thyroiditis, lymph node metastasis, surgical approaches, hospital stay in groups separated by years. The records of the cases who underwent thyroidectomy in Bursa Uludağ University General Surgery Department between January 1999 and December 2018 were reviewed retrospectively. The cases were divided into 4 groups of five years each. Demographic characteristics, presence of multifocal tumor, number of foci, size, capsule invasion, vascular invasion, presence of chronic lymphocytic thyroiditis, non-tumor spread, presence and number of metastatic lymph nodes, size of the largest metastatic lymph node, and surgical procedures of the cases were compared. Postoperative hospital stay was evaluated. There was a significant increase in PTC and multifocal tumors in the groups over the years(p<0,001). While PTMC increased, there was a decrease in non-microcarcinoma PTCs(p<0,001). Tumor size in unifocal PTCs (p<0,001) and total tumor size in multifocal PTCs(p=0,002) tended to decrease. There was a significant increase between the groups in the presence of chronic lymphocytic thyroiditis(p<0,001). While there was a significant increase in total/near-total thyroidectomy and decrease in subtotal thyroidectomy(p<0,001) likewise, there was an increase in lateral neck dissection and a decrease in central neck dissection(p=0,002). When the length of hospital stay was compared, an increase was found in the postoperative 1-day hospital stay compared to the first years(p<0,001). When PTMK sizes were examined, a significant increase was found at 5 mm and below(p<0,001). In this study, it was observed that the size of papillary cancer gradually decreased over a 20-year period, and the frequency of papillary microcarcinoma was gradually increasing. In addition, a significant increase was observed in the rates of total/near-total thyroidectomy and lateral neck dissection over the years when the operations performed on the cases were compared. Current changes in guidelines, increased use of ultrasonography and fine-needle aspiration biopsy, and examination of thyroidectomy specimens by pathologists specialized in their fields were considered as the reasons for the change in our study. Key words: Papillary thyroid carcinoma, papillary thyroid microcarcinoma, multifocal tumor, tumor size