Clinicopathological Characteristics and Surgical Management of Papillary Thyroid Carcinoma in a Tertiary Care Hospital

Open Access

Abstract

ABSTRCAT Background: Papillary thyroid carcinoma (PTC) is the most common endocrine malignancy and generally has an excellent prognosis. However, clinicopathological characteristics and lymph node involvement influence surgical management and postoperative outcomes. This study evaluated the clinicopathological characteristics and surgical management of PTC in a tertiary care hospital in Bangladesh. Methods & Materials: This cross-sectional study was conducted in the Department of Otolaryngology and Head-Neck Surgery at the National Institute of ENT, Dhaka, Bangladesh, from January 2020 to December 2021. A total of 125 patients aged 15-60 years with histopathologically confirmed PTC who underwent total thyroidectomy, with or without neck dissection, were enrolled using purposive sampling. Clinicopathological, operative, and follow-up data were collected from patient interviews and hospital records. Postoperative thyroid function tests and ultrasonography were performed during follow-up. Data were analyzed using SPSS version 23.0, with p<0.05 considered statistically significant. Results: Of the 125 patients, 69.6% were female, 69.6% had tumors ≥2 cm, and 69.6% had clinically positive cervical lymph nodes. Bilateral cervical lymph node involvement was the most common pattern (53.6%), and 80.5% of involved lymph nodes measured ≥0.5 cm. Total thyroidectomy with neck dissection was the most frequently performed procedure (55.0%). During follow-up, FT3 and FT4 levels increased significantly, whereas TSH levels decreased significantly (all p<0.05). Ultrasonography demonstrated a clear thyroid bed in 87.2% of patients, while 12.8% had residual thyroid bed lesions or cervical lymph node positivity. Conclusion: Papillary thyroid carcinoma predominantly affected middle-aged women and was commonly associated with larger tumors and cervical lymph node involvement. Total thyroidectomy with neck dissection was the most common surgical procedure and achieved favorable postoperative outcomes, highlighting the importance of appropriate surgical management and regular postoperative follow-up.