T. Zhan2, A. Ali2, C. Hur2,3, C. C. Lubitz1,2 1Massachusetts General Hospital,Department Of Surgery,Boston, MA, USA 2Massachusetts General Hospital,Institute For Technology Assessment,Boston, MA, USA 3Massachusetts General Hospital,Division Of Gastroenterology,Boston, MA, USA
Introduction:
Incidence of thyroid cancer has been increasing in the United States while survival remains high. With rising cancer detection rate, patients can face high costs of surgeries and numerous ultrasound follow-ups that might be unnecessary. However, there is limited data on surgical pathology diagnosis and follow-ups. We aim to utilize the electronic health records at a tertiary hospital to examine the number of follow-up ultrasounds of thyroid cancer patients.
Methods:
Ultrasound and surgical pathology reports of patients who had thyroid surgeries, more than one thyroid ultrasound from 2000 to 2016 and at least 10 related visits at this hospital have been extracted from the electronic health records . Patients who had surgery from 2000 to 2005 were included for follow-up analysis. Final diagnoses from surgical pathology reports in free text format were extracted and categorized using regular expression in R version 3.3.2. Thyroid ultrasounds, vital status and reason of hospital visit during 10-year follow up were summarized for patients who had surgery from 2000 to 2005.
Results:
In our surgical patient cohort from 2000 to 2005, 579(49.8%) patients had surgeries that led to a final benign diagnosis with a mean of 1.14(SD=2.10) ultrasounds during 10-year follow-up. 584(50.2%) patients had a malignant diagnosis with a mean of 5.1(SD = 3.79) follow-up ultrasounds. Among the malignant group, none had following surgeries with malignant diagnoses (Table 1). 94% of the patients had no following surgeries, of which 76.3% survived without radiotherapy or chemotherapy with mean of 5.3(SD=3.62) follow-up ultrasounds.
Conclusion:
Surgical patients who had malignant pathology diagnosis continued to have high number of ultrasound follow-ups at our hospital while patients with benign diagnosis have less follow-ups or potentially follow up with their local endocrinologists. Most of our surgical cohort survived without having radiotherapy or chemotherapy. It is novel and efficient to use regular expression to extract diagnosis information from free text pathology reports and to provide ultrasound follow-up information comparing surgical patients with benign and malignant diagnosis.
