Prognostic factors in patients with recurrent differentiated thyroid carcinoma.
BACKGROUND
Approximately 20% of patients with thyroid carcinoma have relapse. To evaluate the factors affecting their disease-free survival and prognosis, we studied 68 patients with recurrent differentiated thyroid carcinoma, ranging in age from 5 to 73 years (mean: 47.6 years). Three-fourths of patients were followed for >10 years. Thirty-nine patients were treated with total or subtotal thyroidectomy at first operation; the remainder underwent lesser operations. Fifty-six patients had local recurrence, mostly lymph node infiltration. Twenty-six patients died.


METHODS
Survival curves were constructed using the Kaplan-Meier method. Factors affecting relapse and survival were tested by univariate or multivariate analysis.


RESULTS
Univariate analysis identified age at diagnosis, local tumor extension, and surgical method as significant factors for disease-free survival. These three factors and histology were significant prognostic factors. Multivariate analysis showed age, histology, and disease-free interval as significant and independent variables.


CONCLUSIONS
In high-risk patients, complete resection of thyroid tissue and cervical lymph nodes is critical.
Asakawa
H
H
The Second Department of Internal Medicine, Osaka University Medical School, Japan.
Kobayashi
T
T
Komoike
Y
Y
Tamaki
Y
Y
Matsuzawa
Y
Y
Monden
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D002454:Cell Differentiation / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery