Outcome in papillary carcinoma of the thyroid

During a five-year period, 1958--62, 97 cases of papillary thyroid carcinoma had been diagnosed in Finland. Twenty two of these patients died from this cancer during a follow-up of 13--18 years. Five of them had initially had distant metastases. Of the remainder seven had had no thyroid operation or only a biopsy, nine an operable tumour that invaded through the thyroid capsule (extrathyroid) and only one a primary tumour confined to the thyroid (intrathyroid). The mortality rates were: 83% for patients with distant metastases, 47% for patients with no thyroid operation, 28% for patients with extrathyroid tumours, and 4% for patients with intrathyroid tumours. Death from an intrathyroid or occult papillary carcinoma that does not show initial distant metastases seems to be exceptional, also if the thyroid operation has been unilateral.