Abstract
Background
The prognosis of patients with papillary thyroid carcinoma (PTC) is usually favorable; however, a subset of patients can develop local recurrence or distant metastases. The aim of this study was to evaluate the prognostic factors influencing the recurrence and the survival rate in 950 PTC patients.
Materials and Methods
From 1990 to 2005, 950 consecutive patients affected by PTC were operated on at our Department. We analyzed the prognostic role of the following parameters: gender, age at initial treatment, extent of thyroid surgery, node dissection, tumor size, node metastases, distant metastases, stage, and 131-I therapy.
Results
Seventy-nine patients (8.3%) developed locoregional or distant metastases after an average follow-up of 7.8 years (range 2–17 years); in particular local recurrence was observed in 25 cases and distant metastases in 54 cases. The global 10- and 15-year survival rates were 91.38% and 88.69%, respectively. At univariate analysis, all variables were significantly correlated with recurrence (P = .001) except gender (P = .3); moreover, gender (P = .2), node dissection (P = .5), and node metastases (P = .06) were not significant on 10- and 15-year survival. At multivariate analysis the age at first treatment, T4, M+, stage IV, the extent of thyroid surgery, and the 131-I therapy resulted to be significant and independent prognostic factors (P < .001).
Conclusion
Our data, in disagreement with other staging systems, suggest that gender does not play a significant role both in recurrence and survival. Moreover, the 131-I therapy was a statistically significant prognostic factor at univariate and multivariate analyses.
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References
Mazzaferri EL, Kloos RT. Clinical review 128: current approaches to primary therapy for papillary and follicular thyroid cancer. J Clin Endocrinol Metab 2001; 86:1447–63
Schlumberger MJ. Papillary and follicular thyroid carcinoma. N Eng J Med 1998; 338:297–306
Kjellman P, Zedenius J, Lundell G, et al. Predictors of outcome in patients with papillary thyroid carcinoma. Eur J Surg Oncol 2006; 32:345–52
Pelizzo MR, Toniato A, Grigoletto R. Surgical treatment of papillary thyroid carcinoma : uni and multivariate analysis of prognostic factors (TNM staging system included). J Exp Clin Cancer Res 1997; 16:261–5
Leboulleux S, Rubino C, Baudin E, et al. Prognostic factors for persistent or recurrent disease of papillary thyroid carcinoma with neck lymph node metastases and/or tumor extension beyond the thyroid capsule at initial diagnosis. J Clin Endocrinol Metab 2005; 90:5723–29
Pelizzo MR, Toniato A, Boschin IM, et al. Locally advanced differentiated thyroid carcinoma: a 35 year mono institutional experience in 280 patients . Nucl Med Commun 2005; 26:965–8
Voutilainen PE, Siironen P, Franssila KO, et al. AMES, MACIS and TNM prognostic classification in papillary thyroid carcinoma. Anticancer Res 2003; 23:4283–88
Pasieka JL, Zedenius J, Auer G, et al. Addition of nuclear DNA content to the AMES risk-group classification for papillary thyroid cancer. Surgery 1992; 112:1154–9
Hay ID, Pergstralh EJ, Goellner JR, et al. Predicting outcome in papillary thyroid carcinoma: development of a reliable prognostic scoring system in a cohort of 1779 patients surgically treated at one institution during 1940 through 1989. Surgery 1993; 114:1050–57
Van Nguyen K, Dilawari RA. Predictive value of AMES scoring system in selection of extent of surgery in well differentiated carcinoma of thyroid. Am Surg 1995; 61:151–55
Jukkola A, Bloigu R, Ebeling T, et al. Prognostic factors in differentiated thyroid carcinomas and their implications for current staging classifications. Endocr Relat Cancer 2004; 11:571–79
Lang B, Lo C, Chan W, et al. Staging systems for papillary thyroid carcinoma. A review and comparison. Ann Surg 2007; 245:366–78
Sobin LH, Wittekind C. UICC: TNM Classification of Malignant Tumors, 6th edn. New York:, Wiley-Liss, 2002
Byar D, Green S, Dor P, et al. A prognostic index for thyroid carcinoma: a study of the EORTC Thyroid cancer cooperative group. Eur. J Cancer 1979; 15:472–9
Cady B, Rossi R. An expanded view of risk-group definition in differentiated thyroid carcinoma. Surgery 1988; 104:947–53
Voutilainen P, Shronen P, Franssila K, et al. AMES, MACIS and TNM prognostic classifications in papillary thyroid carcinoma. Anticancer Res 2003; 23:4283–8
DeGroot L, Kaplan E, McCormick M, et al. Natural history, treatment, and course of papillary thyroid carcinoma. J Clin Endocrinol Metab 1990; 71:414–24
Dean DS, Hay ID. Prognostic indicators in differentiated thyroid carcinoma. Cancer Control 2000; 7:229–39
Shaha JP, Loree TR, Dharker D, et al. Prognostic factors in differentiated carcinoma of the thyroid gland. Am J Surg 1992; 164:658–61
Ito Y, Miyauchi A, Jikuzono T, et al.: Risk factors contributing to a poor prognosis of papillary thyroid carcinoma: validity of UICC/AJCC TNM classification stage grouping. World J Surg 2007; 31:838–48
Mazzaferri EL, Jhiang SM. Long term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med 1994; 97:418–28
Hay ID, Thompson GB, Grant CS, et al. Papillary thyroid carcinoma managed at the Mayo Clinic during six decades (1940–1999): temporal trends in initial therapy and long-term outcome in 2444 consecutively treated patients. World J Surg 2002; 26:879–85
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Toniato, A., Boschin, I., Casara, D. et al. Papillary Thyroid Carcinoma: Factors Influencing Recurrence and Survival. Ann Surg Oncol 15, 1518–1522 (2008). https://doi.org/10.1245/s10434-008-9859-4
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DOI: https://doi.org/10.1245/s10434-008-9859-4