Thyroid cancer: a multivariate analysis on influence of treatment on long-term survival.
Contemporary management of patients with follicular pattern thyroid cancer remains uncertain. This retrospective multivariate analysis studied 410 such patients treated in a cancer hospital in the years 1932-72 and providing a follow-up of 20 years. In papillary carcinoma thyroxine administration (P < 0.005) and surgery (P < 0.001) improved survival together with youth (P < 0.001) and being female (P < 0.05). In follicular carcinoma, thyroxine therapy (P < 0.001) increased survival as did surgery but it failed to reach significance (P = 0.19); increasing age (P < 0.001), stage M1 (P < 0.05) and 'complete' radiotherapy (P < 0.05) decreased survival. In anaplastic carcinoma survival was improved by thyroxine therapy (P < 0.001), a new finding, but decreased by stages T3 (P < 0.001) and M1 (P < 0.05); however, radiotherapy, the mainstay in control of local disease, did not increase survival. Overall, total thyroidectomy reduced local recurrence with an increase in complications and no operation gained a significant increase in survival. Radio-iodine achieved no benefit in survival which raises the possibility of confounding. Thyroxine therapy is indicated as initial treatment of follicular cell thyroid cancer.
Staunton
M D
MD
Royal Marsden Hospital, London, UK.
D018263:Adenocarcinoma, Follicular / Q000401:mortality / Q000628:therapy; D000328:Adult; D002277:Carcinoma / Q000401:mortality* / Q000628:therapy*; D002291:Carcinoma, Papillary / Q000401:mortality / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011878:Radiotherapy / Q000379:methods; D012189:Retrospective Studies; D016019:Survival Analysis; D013964:Thyroid Neoplasms / Q000401:mortality* / Q000628:therapy*; D013974:Thyroxine / Q000627:therapeutic use; D016896:Treatment Outcome
D007457:Iodine Radioisotopes; D013974:Thyroxine