Abstract
Background: Our understanding of the natural history of differentiated thyroid carcinoma has improved with the definition of prognostic factors. These prognostic factors have helped us identify patients in various risk groups.
Methods: A retrospective review of a consecutive series of 810 previously untreated patients with papillary carcinoma of the thyroid was undertaken to analyze the prognostic factors and risk groups. There were 403 patients in the low-risk group, 313 in the intermediate group, and 94 classified in the high-risk group.
Results: With a median follow-up of 20 years, 99% survival was achieved in the low-risk group, whereas only 43% survived in the high-risk group. The intermediate-risk group had a 20-year survival of 83%. The favorable prognostic factors included female sex, young age, absence of distant metastases and extrathyroidal extension of the disease, size <4 cm, and low-grade histology. Focality, presence of lymph node metastasis, and pure papillary or mixed variant had no statistical significance on prognosis.
Conclusions: Based on various prognostic factors, low-, intermediate-, and high-risk groups are identified. Patients in the low-risk group have excellent survival (99%). Appropriate selection of surgical and adjuvant treatment should therefore be used based on prognostic factors and risk group stratification.
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References
Parker SL, Tong T, Bolden S, et al. Cancer statistics 1996.CA 1996;65:5–27.
Vassilopoulou-Sellin R. Management of papillary thyroid cancer.Oncology 1995;9:146–51.
Hay ID, Grant CS, Taylor WF, McConahey WM. Ipsilateral lobectomy versus bilateral lobar resection in papillary thyroid carcinoma: a retrospective analysis of surgical outcome using a novel prognostic scoring system.Surgery 1987;102:1088–95.
Cady B, Ross R. An expanded view of risk group definition in differentiated thyroid carcinoma.Surgery 1988;104:947–53.
Shah JP, Loree TR, Dharker D, Strong EW, Begg C, Vlamis V. Prognostic factors in differentiated carcinoma of the thyroid gland.Am J Surg 1992;164:658–61.
American Joint Committee on Cancer.Manual for staging of cancer. 4th ed. Philadelphia: JB Lippincott, 1993.
Sloan W. Of the origin, characteristics and behavior of thyroid carcinoma.J Clin Endocrinol Metab 1954;15:1309–35.
McDermott W, Morgan S, Hamlin EJ. Cancer of the thyroid.J Clin Endocrinol Metab 1954;14:1336–54.
Byar DP, Green SB, Dor P, et al. A prognostic index for thyroid carcinoma. A study of the E.O.R.T.C. Thyroid Cancer Cooperative Group.Eur J Cancer 1979;15:1033–41.
Cady B, Sedgwick CE, Meissner WA, Wool MS, Salzman FA, Werber J. Risk factor analysis in differentiated thyroid cancer.Cancer 1979;43:810–9.
Hay ID. Papillary thyroid carcinoma.Endocrinol Metab Clin North Am 1990;19:545–76.
Cohn K, Backdahl M, Forsslund G, et al. Prognostic value of nuclear DNA content in papillary thyroid carcinoma.World J Surg 1984;8:474–80.
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Shaha, A.R., Shah, J.P. & Loree, T.R. Risk group stratification and prognostic factors in papillary carcinoma of thyroid. Annals of Surgical Oncology 3, 534–538 (1996). https://doi.org/10.1007/BF02306085
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DOI: https://doi.org/10.1007/BF02306085