Cause of death in patients with well-differentiated thyroid carcinoma.
OBJECTIVE
The aim of this study is to examine in detail patients dying of well-differentiated thyroid carcinoma.


METHODS
A retrospective chart review with follow-up.


METHODS
Data were collected from 522 consecutive cases of differentiated thyroid carcinoma treated by one endocrinologist and four surgeons at Mount Sinai Hospital, Toronto, Ontario, Canada, from 1964 to 1999.


RESULTS
Ten patients died as a direct result of thyroid carcinoma; 19 other deaths were unrelated. Five of 102 patients were men (5%) and 5 of 420 were women (1%); the median age at diagnosis was 68.5 years (range, 49-82 y). No cases were stage I; three, stage II; two, stage III; and five, stage IV. Pathologically papillary carcinoma was found in six of the patients who died, follicular carcinoma in three patients, and Hurtle cell carcinoma in one patient. The causes of death were local invasion or compression of the trachea in two cases and distant metastases in eight patients. Median survival was 3.5 years (range, 1 mo-20 y).


CONCLUSIONS
All patients dying of well-differentiated thyroid carcinoma had neck nodes, extrathyroidal spread, or distant metastases at presentation and were older than 49 years of age. Many presented because of their distant metastases. Death resulting from local disease was unusual, with most patients dying of distant metastases.
Beasley
N J
NJ
Department of Otolaryngology, Mount Sinai Hospital, Toronto, Ontario, Canada.
Walfish
P G
PG
Witterick
I
I
Freeman
J L
JL
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology; D018263:Adenocarcinoma, Follicular / Q000401:mortality / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000401:mortality / Q000473:pathology; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009864:Ontario; D012189:Retrospective Studies; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000401:mortality* / Q000473:pathology