Life expectancy is not significantly reduced in 86% of DTC patients; only patients at least 45 yr old with extensive local invasion, lateral lymph node metastases, and/or distant metastases (TNM stages IVa, IVb, and IVc) at diagnosis showed a clearly lower life expectancy.

No abstract

Before adopting low initial activity RIT for, especially older, low-risk patients, results of long-term followup should be regarded critically. Low-activity RIT in older, high-risk patients is not to be recommended.

with DTC (age range, 3-18 years) was collected from 65 clinical institutions in Germany. Characteristics of 80 females and 34 males were evaluated and the influ-1 Clinic for Nuclear Medicine and Tumor Center ence of age, gender, histology, multicentric growth, tumor stage, and lymph node University of Würzburg, Würzburg, Germany. involvement on distant metastases was tested using multivariate discriminant anal-2 Clinic for Pediatrics, University of Lübeck, Lü-ysis. Comparison between groups was performed using the Student's t test and beck, Germany. chi-square test. Correlation between incidence and age was assessed by linear regression analysis. RESULTS. The overall incidence of thyroid carcinoma in females was higher than in males, with a peak of female/male ratio occurring at puberty. The incidence of DTC correlated with age in females õ 16 years (correlation coefficient [r] Å 0.84; P Å 0.0006), which was more pronounced in children with papillary thyroid carci-noma (PTC) (r Å 0.83; P Å 0.006) but not in those with follicular thyroid carcinoma (FTC) (r Å 0.20; P Å 0.16). FTC was associated with less advanced disease (P Å 0.009), fewer lymph nodes involved (P Å 0.007), and fewer metastases (P Å 0.02) compared with PTC. Males tended to have a higher risk for distant metastases. However, statistical analysis failed to reach a level of significance (P Å 0.08). Multi-variate analysis revealed tumor stage as the only powerful factor (P Å 0.02) correlated with distant metastasis.

After (near) total thyroidectomy and successful (131)I ablation, RFS does not differ between patients classified as high-risk and those classified as low-risk based on TNM stage at diagnosis. Consequently, the follow-up protocol should be determined on the basis of the result of initial treatment rather than on the initial tumour classification.

High-dose calcium is a more potent and better-tolerated hCT stimulator than is pentagastrin. The reference ranges for basal and stimulated hCT established via automated chemiluminescent assay were lower than those reported for other assays.

Iodine prophylaxis does influence the distribution of the histologic types of thyroid cancer and leads to an increase in the ratio of papillary versus follicular carcinoma. Our study supports the hypothesis that the benefits of correcting iodine deficency outweigh the risks of iodine supplementation.

Objective: Papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) show considerable differences in disease stage at initial presentation. The aim of this study was to investigate whether there are differences in tumour-specific survival if initial staging is accounted for. Design: Retrospective chart review study. Patients: The study sample comprised 875 PTC and 350 FTC patients (856 females, 369 males, mean age 47.8 years) treated in our hospital from 1978 to 2002. All patients received total thyroidectomy with subsequent I-131 ablation except for those patients with an isolated papillary microcarcinoma. Methods: Kaplan-Meier analyses and Cox-regression analyses were performed to assess the influence of histology on thyroid cancer-specific survival. Results: FTC patients were on average older, more likely to be male, presented with a larger tumour and more frequently had multifocal carcinoma and distant metastases than PTC patients, whereas they presented less frequently with extrathyroidal invasion or lymph node metastases. Twenty-year tumour-specific survival in PTC was 90.6% and in FTC 73.7% (P!0.001). In multivariate analysis the presence of distant metastases (P!0.001), age (P!0.001), tumour size (PZ0.001) and the presence of extrathyroidal invasion (PZ0.007), but not histology (PZ0.26), were independent determinant variables for tumour-specific survival. Conclusion: There is no difference in tumour-specific survival between PTC and FTC when accounting for the presence of metastases, age, tumour size and the presence of extrathyroidal invasion.