Thyroid carcinoma: a clinical and pathologic study of 125 cases

Retrospective clinicopathological study of 125 thyroid carcinoma cases followed for 9 to 19 years was performed. Case selection for unfavorable histologic type and advanced disease was observed for referred cases. All medullary and anaplastic tumors were in patients over age 40; younger patients all had papillary and follicular carcinoma. Actuarial survival rates showed favorable outcome from papillary carcinoma followed by follicular and medullary or anaplastic tumors. Within the papillary carcinoma group, older age and male sex adversely affected survival; the former appeared related to clinical stage at presentation. Clinically palpable papillary carcinomas that were poorly circumscribed or showed vascular invasion were associated with poorer survival than tumors without these features. For papillary carcinomas under 1.5 cm, soft tissue invasion, vascular invasion, and occult lymph node metastases did not effect disease free survival. Two deaths from thyroid cancer were observed in this group, however, in patients who presented initially and with distant metastases. The biology of these small lesions is briefly discussed.