[Thyroid carcinoma: evaluation of prognostic factors]

Between 1990 and 1997, 36 thyroid cancer patients were observed at the III Department of Surgical Oncology, Regina Elena Cancer Institute in Rome. There were 31 (86.1%) women and 5 (13.9%) men, with a mean age of 47.7 years (range 17-72). Diagnostic data consisted of: papillary carcinoma in 25 patients, follicular carcinoma in 9 and Hürthle cell carcinoma in 1. Twenty patients were less than 45 years old (15 papillary and 5 follicular carcinoma) and 16 were more than 45 years old (10 papillary and 4 follicular carcinoma, 1 Hürthle cell carcinoma and 1 with undifferentiated cancer). We performed total thyroidectomy in 32 cases and isthmectomy in 3 (2 papillary carcinoma, T1, < 45 years, 1 follicular carcinoma with minimal invasion). At the time of diagnosis, 6 patients with papillary carcinoma showed signs of local metastasis. No patients exhibited distant diffusion. A follow-up was performed at mean 41 months (2-84 months). Two patients with follicular carcinomas had been treated with radioiodine and showed disease progression with distant metastasis. Our results coincide with the literature on this topic. Total thyroidectomy is preferred, in low-risk patients as well, because subsequent radioiodine treatment and disease relapse monitoring are facilitated. Lateral cervical lymphadenectomy was performed only in cases when there was clinical evidence of metastasis and recurrent disease at this level has never been observed.