Actualities in the Diagnosis and Treatment of thyroid Cancer in Albania

Abstract

Thyroid cancer remains the most common endocrine malignancy and accounts for almost 1% of human cancer. Early positive diagnosis of thyroid cancer in an apparently benign nodule is sometimes a difficult challenge. Over the past three decades, the incidence of thyroid cancer has increased almost two fold worldwide, without any changes in the mortality rates. The aim of this short communication is to present the actual status of diagnosis and treatment of thyroid cancer in Albania. In our study we have analyzed the preoperative clinical database of 262 patients, divided in 206 females and 56 males, admitted in the Clinic of General Surgery, UHC "Mother Theresa" in Tirana in the timeframe 2004-2011; all with a positive histopathologic diagnosis of thyroid diseases. The histologic types of thyroid cancer cases were: papillary 28 (67%) patients; follicular 10 (24%) patients, medullary 3(7%) and anaplastic 1(2%) patient. Final data obtained from FNAB were: Uncertain-18%; Benign-62%, Suspicious-7% and Malignant -13%. The sensitivity of FNAB was 94%, meanwhile specificity was 96%. The overall incidence of thyroid cancer in albanian population is 0, 6/100 000, being slightly greater in females. Evaluating all thyroid nodules for malignancy is difficult and sometimes unproductive, because thyroid carcinoma is rare. Fine Needle Aspiration Biopsy is the procedure of choice in evaluating suspicious thyroid nodules and was used in all our patients with a sensitivity of 94%. Close collaboration between different specialties is the key to correct preoperative thyroid cancer diagnosis and treatment. FNAB remains the most accurate diagnostic method detecting thyroid cancer. Optimal treatment of thyroid cancer and the associated survival depends mostly in a multidisciplinary treatment approach, focused on surgery. All actual guidelines agree that tot Thyroidectomy and other therapeutic modalities, such as radioiodine treatment or adjuvant radiation are necessary for the maximum survival of these patients.