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Mortality from papillary thyroid carcinoma: A case‐control study of 56 lethal cases
Author(s) -
Smith Steven A.,
Hay Ian D.,
Goellner John R.,
Ryan John J.,
McConahey William M.
Publication year - 1988
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19881001)62:7<1381::aid-cncr2820620724>3.0.co;2-r
Subject(s) - medicine , retrospective cohort study , thyroid carcinoma , papillary thyroid cancer , cancer , carcinoma , disease , thyroid , thyroid cancer , respiratory disease , surgery , cohort , presentation (obstetrics) , lung
To document the presentation, findings, therapy, and postoperative course of lethal papillary thyroid carcinoma (PTC), 56 fatal cases were studied in a retrospective case‐matched control fashion. These patients and their controls were taken from a larger series receiving their primary treatment at one institution (Mayo Clinic; 1946–1970). Mean follow‐up for the lethal cohort was 8.5 years and 16.6 years for controls. Age, sex, tumor size, histologic grade, extent of disease at presentation, European Organization for Research on Treatment of Cancer (EORTC) and AGES scores (patient's age, tumor grade, tumor extent, and tumor size), and DNA ploidy pattern were found to be significant prognostic factors. The immediate causes of death were most frequently either local airway obstruction or respiratory insufficiency from pulmonary metastases. The results suggest that it is possible, at the time of initial treatment, to assess an individual patient's risk of dying from PTC. Aggressive postoperative adjunctive therapy should be restricted to that minority of patients who are at highest risk of death from PTC.