Prognostic variables of papillary and follicular thyroid carcinoma patients with lymph node metastases and without distant metastases.

Abstract

From 1977 through 1995, 1013 thyroid carcinoma patients received treatment and were followed up at Chang Gung Medical Center in Taiwan. To evaluate the prognostic variables of papillary and follicular thyroid carcinomas with limited lymph node metastases, a retrospective review of these patients was performed. Of these patients, 910 had papillary or follicular thyroid carcinoma, and 119 patients were categorized as clinical stage 2 with limited neck lymph node metastases only at the time of diagnosis. The patients were categorized into two groups as no recurrence and local recurrence or distant metastasis at the end of 1997. After the operations, radioactive iodide ( 131 I) treatments were performed in 114 patients and external radiotherapy for neck region or distant metastases in 18 patients. The median follow-up period of these patients was 5.4 years. Clinical variables were coded in our computer for statistical analysis. After the treatments, 93 patients remained disease-free; 10 were in stage 2; 5 in stage 3; and 11 aggravated to stage 4. Of the clinical variables, age, postoperative first 131 I uptake scans, and 1-month post-operative thyroglobulin levels revealed statistically significant differences between the group which improved and the group which did not. During the follow-up period, five patients died; three patients died of thyroid cancer and two died of intercurrent diseases. Patients with papillary thyroid carcinoma revealed a higher percentage of lymph node metastases. Although limited lymph node metastases did not influence survival rate, patients with poor Endocrine-Related Cancer (1999) 6 109-115 prognostic factors need more aggressive treatment to avoid progression of the cancer. Lin et al.: Thyroid carcinoma with lymph node metastases 110influence of limited lymph node metastases of welldifferentiated thyroid carcinoma at the time of diagnosis and the prognostic variables of patients, 1013 thyroid cancer patients were retrospectively reviewed at our medical center. Subjects and methodsFrom January 1977 through December 1995, 1013 thyroid carcinoma patients received primary treatment and were followed-up at Chang Gung Medical Center in Linkou, Taiwan. Of these patients, 910 had papillary or follicular thyroid carcinomas. Either near total thyroidectomy or modified radical neck thyroidectomy was performed on 689 patients after the tumors were found to be malignant by preoperative fine-needle aspiration or frozen sections. Two hundred and ten patients received either subtotal thyroidectomy or lobectomy only. Most of these patients received limited lymph node dissection in the anterior compartment of the neck only unless there were clinically detectable lymph node enlargements. One patient received biopsy only. Ten patients were referred from other hospitals without detailed records of the surgical methods used.Four to six weeks after the operations, whole body 131 I image scans were performed after using 5 mCi 131 I for diagnostic scans. When 5 mCi 131 I scan was used for diagnos...

Understanding the Relationship Between Age and Thyroid Cancer

“…The association between older age and shorter survival cannot be explained by different stage at diagnosis, tumor differentiation, treatment, or socioeconomic variables [2,16]. However, localized PTC or follicular thyroid cancer has an excellent prognosis and a weak dependence on age, whereas WDTC with regional or distant metastases has a survival rate that is strongly dependent on age [1,2,[15][16][17]. In addition to the greater likelihood of radioiodineresistant disease with advanced age, there are other changes in the thyroid that occur with normal aging.…”

Follicular Thyroid Carcinoma: From Diagnosis to Treatment

“…Compared with papillary thyroid carcinoma there is a higher incidence of follicular thyroid carcinoma presenting with bone metastases [43][44][45]. Unfortunately, until now there are few cases cured after the diagnosis of bone metastases with follicular thyroid carcinoma.…”

Lymph node management in clinically node-negative patients with papillary thyroid carcinoma

“…In patients with differentiated thyroid carcinoma, Hughes et al in a matched-pair analysis (n = 200), and Lin et al, in a retrospective study (n = 1013), have reported a correlation between node invasion and an increased rate of local recurrence [2,3]. However, in these studies LNM did not influence the survival rate [2,3].…”