Conradie Wilhelmina, Luvhengo Thifhelimbilu, Lübbe Jeanne Adele, Afrogheh Amir, Bestbier Aneldi, Bhuiyan Mirza, Bombil Ifongo, Čačala Sharon Raye, Cairncross Lydia, Changfoot Chanel, Edge Jenny, Jackson Brandon S, Jehle Hansjörg S, Jonas Lusanda, Lukusa Mpoyi Ruphin, Makgoka Malose, Martin Lindi, Nel Daniel, Patel Mohamed Quraish, Sishuba Nosisa Thabile, Razack Rubina, Baatjes Karin
Department of Surgery, Tygerberg Hospital, University of Stellenbosch, Cape Town, South Africa.
Department of Surgery, University of Witwatersrand, Johannesburg, South Africa.
World J Surg. 2024 Dec;48(12):2863-2870. doi: 10.1002/wjs.12353. Epub 2024 Sep 22.
In South Africa (SA), data on the incidence of thyroid cancer is limited. Papillary thyroid carcinoma is by far the most common malignancy in developed countries; however, a preponderance of follicular thyroid cancer in developing countries, despite iodized salt, has been observed. The aim of this study was to describe the national landscape of thyroid cancer in SA with reference to pathological subtypes, surgical outcomes, and treatments offered.
A multi-institutional retrospective review of thyroid cancer patients operated on between January 2015 and December 2019 was performed. Public hospitals with associated academic institutions were included. Data were collected from theater registers, pathology, and radiology records. Statistical analysis was done to determine intergroup significance.
A total of 464 thyroid cancer cases from 13 centers across five SA provinces were identified. Most patients presented with a mass (67%). Ultrasound was performed in 82% of patients, and 16.3% underwent surgery without pre-operative cytology. Of the histologically confirmed thyroid cancers, 61.8% were papillary and 22.1% follicular thyroid cancer. There was a significant association between subtype and geographical area, and T-stage and operation performed. Surgical complication rates included hematoma in 1.8%, post-operative hypocalcemia in 28.7%, and recurrent laryngeal nerve injury in 3.5%.
This first national review describes the landscape of thyroid cancer in SA, revealing considerable differences compared to international studies. It provides valuable insight into the unique South African experience with this disease. In addition, this study serves as an impetus towards a prospective national registry with real-world data informing contextualized guidelines.
在南非（SA），甲状腺癌发病率的数据有限。甲状腺乳头状癌是发达国家迄今为止最常见的恶性肿瘤；然而，尽管有碘盐供应，但在发展中国家观察到滤泡状甲状腺癌占优势。本研究的目的是参照病理亚型、手术结果和所提供的治疗方法，描述南非甲状腺癌的全国概况。
对2015年1月至2019年12月期间接受手术的甲状腺癌患者进行多机构回顾性研究。纳入了设有相关学术机构的公立医院。数据从手术记录、病理和放射学记录中收集。进行统计分析以确定组间差异的显著性。
共识别出来自南非五个省份13个中心的464例甲状腺癌病例。大多数患者表现为肿块（67%）。82%的患者进行了超声检查，16.3%的患者未进行术前细胞学检查就接受了手术。在组织学确诊的甲状腺癌中，61.8%为乳头状癌，22.1%为滤泡状甲状腺癌。亚型与地理区域、T分期与所进行的手术之间存在显著关联。手术并发症发生率包括血肿1.8%、术后低钙血症28.7%、喉返神经损伤3.5%。
这项首次全国性综述描述了南非甲状腺癌的概况，揭示了与国际研究相比存在的显著差异。它为南非在这种疾病方面的独特经验提供了有价值的见解。此外，本研究推动了建立一个前瞻性全国登记处，利用真实世界数据制定背景化指南。
