Caracteristicas clínicas, manejo y evolución del Carcinoma de Tiroides en el Instituto Autónomo Hospital Universitario De Los Andes, Mérida, Venezuela: Importancia de la clasificación de riesgo.

Objective: To describe the clinical characteristics, management and evolution of differentiated thyroid carcinoma (DTC) at the Autonomous Institute University Hospital of the Andes. Methods: Observational descriptive study. The records of patients with CDT in the period January 2010-July 2015 were reviewed. Demographic, clinical, paraclinical, treatment and evolution data were recorded. The system TNM classification of malignant tumors and the American Thyroid Association classification of risk were applied. Associations between variables were investigated. Results: A total of 207 records were reviewed, the female sex was the most affected (6:1 ratio), the average age was 44.5 years, and the most affected age group was 31 to 40 years. The most important symptom was the increase in volume in the anterior neck in 97.4%. Total thyroidectomy was performed in 92.8% of the cases. The most frequent histological variety was papillary, 92.9%. Goiter was multinodular in 52.6%, and compared to uninodular, it ocurred at an older age and showed a significantly higher frequency of extracapsular extension, lymphatic invasion and more advanced TNM stages. The 59.7% had low risk of recurrence. Patients with moderate-high risk were older and had an increased risk of extracapsular extension and lymph node metastases (p <0.0001). Conclusion: The clinical characteristics, management and evolution of this group of patients with DTC is similar to that reported in the literature, except for a more frequent presentation with multinodular goiter, which showed a more aggressive pattern. The validity of the risk classification in predicting probable recurrence is checked.