Conservative management of patients with intrathyroidal well-differentiated follicular thyroid carcinoma.
BACKGROUND
Total or near-total thyroidectomy for the treatment of follicular thyroid carcinoma (FTC). The prognosis of patients with low-risk FTC, however, is excellent, and thus total thyroidectomy may not be justifiable in such patients.


METHODS
A retrospective review identified 61 patients diagnosed with intrathyroidal well-differentiated FTC between 1958 and 1991.


RESULTS
Median age at diagnosis was 42 years (range, 15-78 years). Most patients (90.2%) had a lobectomy or subtotal thyroidectomy. Median tumor size was 3.0 cm (range, 0.9-9.5 cm). Fifty-eight patients (95.1%) received thyroid hormone supplementation, and 5 (8.2%) received radioactive iodine ablation postoperatively. Median follow-up was 11 years (range, 3-35 years). Local recurrence, metastasis, or both developed in 3 patients (4.9%), and all subsequently died of thyroid cancer. The cumulative 10- and 15-year cancer-specific survival rate was 96.5%. Factors significantly related to worse survival were oxyphilic histology (log-rank, P =.00) and tumor size of more than 4 cm (P =.001). However, neither was found to be an independent predictor of outcome by Cox multivariate analyses (P =.7 and.9, respectively). The extent of initial operation (unilateral versus bilateral procedure) was not significantly related to survival (P =.52).


CONCLUSIONS
Conservative management consisting mainly of lobectomy or subtotal thyroidectomy and thyroid hormone supplementation is associated with favorable outcome of patients with intrathyroidal well-differentiated FTC.
Saadi
H
H
Department of Internal Medicine, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE.
Kleidermacher
P
P
Esselstyn
C
C
D018263:Adenocarcinoma, Follicular / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011182:Postoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D013963:Thyroid Hormones / Q000627:therapeutic use*; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D013965:Thyroidectomy; D016896:Treatment Outcome
D013963:Thyroid Hormones