Erstsymptome bei Schilddrüsenmalignomen: Einfluß von Alter und Geschlecht in einem Jodmangelgebiet: Erfahrungen an 1116 Patienten

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Abstract
Initial symptoms of thyroid cancer were collected and analyzed for 1116 patients with thyroid cancer in an iodine-deficient region, retrospectively for the period 1960-80 (604 patients), prospectively for 1981-87 (512). Using the WHO classification, 56.1% of patients had papillary, 32.7% follicular, 4.8% C-cell, 3.7% anaplastic and 2.7% various other malignant tumors. In 40% of all patients the initial sign had been a solitary intrathyroid nodule. Cervical lymph node swelling as initial sign had been significantly more frequent in men (21.1%) than in women (10.3%; P < 0.003). In patients aged under 40 years the cervical lymph node signs were three times as common as among those over 50 years. Distant metastases as initial sign of papillary carcinoma were seen only in those over 60 years. Tumor stages T3 and T4 were seen significantly more frequently in over 60-year-olds (42.2%) than under 40-year-olds (25.1%; P < 0.001), independent of histological type. Composition and initial signs of this patient cohort in an iodine-deficient region differed only slightly from those in an iodine-rich region.