[Differentiated thyroid carcinoma in an endemic area. Clinical aspects, prognosis, therapeutic considerations]

A retrospective analysis was undertaken of 179 cases of differentiated thyroid carcinoma (89 follicular and 90 papillary; first operations 1952-1977). At the time of the diagnosis there was no significant difference between the two types of malignancy as to age, sex, stage of tumour and degree of local radical operation. Nor was there any difference as to clinical course, but for papillary carcinoma the recurrence rate was higher and the survival time significantly shorter. Simple histological classification as to type did not help in prognosis. Compared with published reports, the unfavourable course of papillary carcinoma can be explained by the high proportion of haematogenous metastasizing tumours and the great prognostic significance of distant metastases, especially with papillary carcinoma. The differences in prognosis of other clinical examinations is ascribed to the broad spectrum of tumour-biological aggressivity which hides under the expression "differentiated carcinoma". Our results underline the need to take into account different clinical and histopathological influences which differ for each tumour type.