Multivariate analysis of survival in differentiated thyroid cancer: the prognostic significance of the age factor

Schelfhout, L.J.D.M.; Creutzberg, Carien L.; Hamming, J. F.; Fleuren, Gert Jan; D, Smeenk; Hermans, J.; Velde, Cornelis J.H. van de; Goslings, B. M.

doi:10.1016/0277-5379(88)90276-3

Cited by 91 publications

(48 citation statements)

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“…In a study by Ronga et al [14], multivariate analysis revealed that age at diagnosis was the most important factor in conditioning the time to death. In contrast, Schelfhout et al [15] did not recommend the use of age as a guide for therapeutic decisions in DTC. In our study, 10-year DFS and OAS rates among those >45 years old were 70% and 81.5%, respectively.…”

Section: Discussionmentioning

confidence: 93%

“…Classifying systems, including TNM, AMES, AGES, and MACIS, were developed for determining the prognosis of DTC patients, to tailor postoperative adjunctive therapy, and for making decisions regarding the frequency and intensity of follow-up care [3]. The most predictive prognostic factors included in these schemes are age, the extent of the tumor, and the presence of distant metastases [4]. Several prognostic variables, such as vascular invasion and lymph node involvement, are defined independent of these factors, but they are not in clinical use in the follow-up of DTC patients [5].…”

Section: Introductionmentioning

confidence: 99%

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Prognostic factors determining survival in differentiated thyroid cancer

Gülçelik¹,

Gülçelik²,

Kuru³

et al. 2007

Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Prognostic factors determining survival in differentiated thyroid cancer

Gülçelik¹,

Gülçelik²,

Kuru³

et al. 2007

Journal of Surgical Oncology

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“…MOST well differentiated thyroid cancer cases progress slowly in their clinical courses [1][2][3]. Around 8 to 33% of the follicular thyroid carcinoma patients presented with distant metastases at the time of diagnosis [4][5][6]. In our recent study, 33.7% of the follicular thyroid cancer cases presented with distant metastases during the follow-up period [7].…”

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confidence: 99%

Follicular Thyroid Carcinomas with Lung Metastases: A 23-Year Retrospective Study

Lin

Chao

2004

Endocr J

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Abstract. Limited clinical information is specified in the presentations, results of treatment and prognostic factors of follicular thyroid carcinoma with lung metastases. In order to better characterize the information, we retrospectively analyzed the data of 2,003 thyroid cancer patients who received treatment and follow-up at the Chang Gung Memorial Hospital during the period from January 1979 to December 2002. There were 1,516 cases of papillary and 272 cases of follicular thyroid carcinomas. In the study, lung metastases of the follicular thyroid carcinomas were defined as postoperative or follow-up chest X-ray, diagnostic or therapeutic 131 I scan with positive finding of lung metastases. Serum thyroglobulin (Tg) levels under thyroxine treatment of patients with lung metastases had to be over 1.5 ng/mL. Of the follicular thyroid carcinomas, there were 70 (25.7%) with lung metastases including 50 females (mean age 54.1 ± 12.6 years old) and 20 males (mean age 59.4 ± 12.0 years old). Of the 70 patients, there were 53 patients (75.7%) who presented with lung metastases at the time of diagnosis. Of the 70 patients of follicular thyroid carcinoma with lung metastases, 30 patients (42.9%) died at the end of the follow-up, and only 4 patients improved to disease free status. The 5, 10, 15, and 20 year survival rates in these patients were 68.5%, 54.0%, 41.6%, 27.7%, respectively. Age, post-operative Tg level and tumor size are important prognostic factors which are demonstrated to be significantly different statistically between lung metastases group and the group of the patients without distant metastasis. Otherwise, only the tumor size and accumulative dose of 131 I therapy demonstrate a significant difference between survival and mortality groups. Seventeen of the 70 patients developed lung metastases during the follow-up period. Mean period between diagnosis and recurrence of these patients was 3.6 ± 0.9 years. Over 75% of follicular thyroid carcinoma with lung metastases was diagnosed at the time of presentation. Forty percent (28/70 cases) of the follicular thyroid carcinoma with lung metastases had history of thyroid surgery in this study. If lung metastases are diagnosed in follicular thyroid carcinoma, it will be followed by a poor prognosis. Older patients, higher postoperative Tg, and larger tumor size in follicular thyroid carcinoma need aggressive postoperative treatment. MOST well differentiated thyroid cancer cases progress slowly in their clinical courses [1][2][3]. Around 8 to 33% of the follicular thyroid carcinoma patients presented with distant metastases at the time of diagnosis [4][5][6]. In our recent study, 33.7% of the follicular thyroid cancer cases presented with distant metastases during the follow-up period [7]. When comparing the clinical presentations of the follicular thyroid cancer with other series, a relatively high incidence of the distant metastases was noted [3,6,7]. Hematogenous spreading had been known as the main way of distant metastases in follicular thyroid carcinoma. T...

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“…This could be a result of fewer patients in most studies, which means that small variations in the variables analyzed can lead to a prognostic factor being significant or not. As a general rule, the following prognostic factors have been reported for this type of carcinoma: age, tumor differentiation, vascular invasion, distant metastasis, nodular affectation, capsular invasion, and tumor extension (13,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37), although, as we have already mentioned, there is a great amount of variability between studies.…”

Section: Discussionmentioning

confidence: 83%

Are prognostic scoring systems of value in patients with follicular thyroid carcinoma?

Rı́os¹,

Rodrı́guez²,

Ferri

et al. 2013

European Journal of Endocrinology

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Purpose: Most prognostic systems for differentiated carcinoma have been designed for papillary carcinoma. Objective: To analyze the value of the existing prognostic systems for evaluating follicular carcinoma and to determine whether any of them have a better predictive effect. Methods: A total of 66 follicular carcinomas were analyzed. The following prognostic systems were studied: EORTC, AGES, AMES, MACIS, TNM, and NTCTCS. Results: The AGES and AMES systems did not demonstrate a good prognostic correlation. In the EORTC system, the rate of disease-free patients was 89% in group 1, 75% in group 2, 69% in group 3, and 0% in group 4. The MACIS system showed 83, 60, 67, and 0% of disease-free patients respectively. The TNM system showed 81, 71, 50, and 0% of disease-free patients respectively. Finally, the NTCTCS system demonstrated 100, 84, 53, and 0% of disease-free patients respectively. Cox's regression analysis was used to calculate the proportion of variation in survival time explained (PVE). The prognostic classification system with the greatest survival prediction was EORTC at 67.64% of PVE, followed by TNM at 62.5% of PVE, and MACIS at 57.82% of PVE. Conclusions: MACIS and TNM are good prognostic systems for evaluating follicular thyroid carcinoma, although the one with the most prognostic value was the EORTC system.

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Multivariate analysis of survival in differentiated thyroid cancer: the prognostic significance of the age factor

Cited by 91 publications

References 20 publications

Prognostic factors determining survival in differentiated thyroid cancer

Prognostic factors determining survival in differentiated thyroid cancer

Follicular Thyroid Carcinomas with Lung Metastases: A 23-Year Retrospective Study

Are prognostic scoring systems of value in patients with follicular thyroid carcinoma?

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