Prognostic factors determining survival in differentiated thyroid cancer

Differentiated thyroid cancer (DTC) is among the most curable cancers. We evaluated the prognoses of patients with DTC from an iodine-deficient area.

Four hundred twenty-two patients with thyroid cancer who underwent surgery between 1992 and 2000 at the Ankara Oncology Hospital were evaluated. Three hundred eighty-two patients with DTC were included. Gender, age, histopathological type, tumor size, capsular invasion and vascular invasion, distant metastasis, TNM, and AMES-MACIS scoring were analyzed.

The 10-year disease-free survival rate was 72% and the overall survival rate was 88%. Age >/=45 years at presentation, follicular thyroid cancer, tumor extension beyond the thyroid capsule, vascular invasion, distant metastasis, increasing tumor size, stage, and high MACIS-AMES scores were found to be statistically significant adverse prognostic factors in univariate analysis for DFS and OAS. Multivariate analysis for DFS and OAS confirmed that distant metastasis, follicular thyroid cancer, tumor extension beyond the thyroid capsule, vascular invasion, primary tumor size, TNM stage, and high MACIS score were independent prognostic factors.

In DTC patients, in addition to traditional risk factors, prognostic factors, such as vascular invasion and capsular invasion, need to be evaluated; not only for achieving an adequate therapeutic approach, but also for avoiding overtreatment of low-risk patients.