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Prognostic Factors in Well‐Differentiated Thyroid Carcinoma
Author(s) -
Cushing Sharon L.,
Palme Carsten E.,
Audet Nathalie,
Eski Spiro,
Walfish Paul G.,
Freeman Jeremy L.
Publication year - 2004
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/01.mlg.0000149442.22393.e2
Subject(s) - medicine , thyroid carcinoma , thyroid cancer , thyroidectomy , stage (stratigraphy) , retrospective cohort study , multivariate analysis , disease , proportional hazards model , oncology , cancer , thyroid , surgery , paleontology , biology
Objectives: To test the prognostic significance of standard clinicopathologic factors in patients with well‐differentiated thyroid carcinoma (WDTC). Study Design: A retrospective chart review of the thyroid cancer database at Mount Sinai Hospital (Toronto, Canada 1963–2000) was carried out. Methods: All patients consecutively treated for WDTC with a follow‐up period of at least 5 years were eligible for inclusion. Relevant patient, tumor, treatment, and outcome data were collected. The main outcome measures were recurrence rate, actuarial overall, and disease‐specific survival at 20 years. Results: Three hundred and thirty‐three patients (F 275, M 58) with a median age of 39.7 (range 9–82.9) years were eligible for inclusion in this study (median follow‐up 10.4 years, range 5–34.4 years, minimum 5 years). The recurrence rate was 15.6% (52 /333). The overall and disease‐specific survival at 10 years was 97.5% and 98.5%, respectively. Likewise, the overall and disease‐specific survival at 20 years was 88.4% and 93.3%, respectively. Clinicopathologic factors significant on multivariate regression for the development of disease recurrence included family history of WDTC, advanced stage, and total thyroidectomy (all P < .05). Similarly, advanced stage on presentation was associated with a worse disease‐specific survival on multivariate regression (all P < .05). There was a trend for age 60 or greater to predict disease‐specific survival ( P = .09). Conclusions: WDTC is associated with a significant recurrence rate but good disease‐specific survival. The most important prognostic factors are family history of WDTC, extent of surgical treatment (i.e., total thyroidectomy), and advanced initial stage of disease, with a trend for age 60 years and older.