Differentiated thyroid cancer and outcome in iodine deficiency.
OBJECTIVE
Factors influencing prognosis and long-term outcome of thyroid cancer have been described by several groups. We wished to asses the previously described prognostic factors in a moderately iodine deficient region in Hungary.


METHODS
Four hundred and fifty-four out of 492 patients who had surgery for papillary thyroid cancer (PTC, 386 cases) and follicular thyroid cancer (FTC, 106 cases) between 1971 and 1998 were analyzed. Survival curves were compared using the Kaplan-Meier method and Cox regression analysis.


RESULTS
The 10 and 20-year survival rates were 87.9 and 84% for PTC, and 78.2 and 78.2% for FTC. In PTC, extrathyroidal invasion (p<0.0001), lymph node metastasis (p<0.0001), distant metastasis (p<0.0001), and age over 40 years (p=0.002) were significant adverse predictors. In FTC, extrathyroidal invasion (p=0.003) distant metastases (p<0.0001), and age over 40 years (p=0.011) were significant adverse predictors.


CONCLUSIONS
Iodine intake did not appear to influence survival. The incidence of follicular cancer, which has less favourable prognosis, was higher in iodine deficient regions. This supports the importance of iodine supplementation in these areas.
Gyory
F
F
1st Department of Surgery, Medical and Health Science Center, University of Debrecen, P.O. Box 27, H-4012 Debrecen, Hungary. gyoryferenc@hotmail.com
Balazs
Gy
G
Nagy
E V
EV
Juhasz
F
F
Mezosi
E
E
Szakall
Sz
S
Math
J
J
Lukacs
G
G
D018263:Adenocarcinoma, Follicular / Q000150:complications* / Q000473:pathology / Q000601:surgery; D000231:Adenocarcinoma, Papillary / Q000150:complications* / Q000473:pathology / Q000601:surgery; D000328:Adult; D003677:Deficiency Diseases / Q000150:complications*; D005260:Female; D006801:Humans; D006814:Hungary; D007455:Iodine / Q000172:deficiency*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D013964:Thyroid Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome
D007455:Iodine