title: Prognostic factors in well-differentiated thyroid carcinoma.
abstract: OBJECTIVE
  To test the prognostic significance of standard clinicopathologic factors in patients with well-differentiated thyroid carcinoma (WDTC).
  
  
  METHODS
  A retrospective chart review of the thyroid cancer database at Mount Sinai Hospital (Toronto, Canada 1963-2000) was carried out.
  
  
  METHODS
  All patients consecutively treated for WDTC with a follow-up period of at least 5 years were eligible for inclusion. Relevant patient, tumor, treatment, and outcome data were collected. The main outcome measures were recurrence rate, actuarial overall, and disease-specific survival at 20 years.
  
  
  RESULTS
  Three hundred and thirty-three patients (F 275, M 58) with a median age of 39.7 (range 9-82.9) years were eligible for inclusion in this study (median follow-up 10.4 years, range 5-34.4 years, minimum 5 years). The recurrence rate was 15.6% (52 /333). The overall and disease-specific survival at 10 years was 97.5% and 98.5%, respectively. Likewise, the overall and disease-specific survival at 20 years was 88.4% and 93.3%, respectively. Clinicopathologic factors significant on multivariate regression for the development of disease recurrence included family history of WDTC, advanced stage, and total thyroidectomy (all P < .05). Similarly, advanced stage on presentation was associated with a worse disease-specific survival on multivariate regression (all P < .05). There was a trend for age 60 or greater to predict disease-specific survival (P = .09).
  
  
  CONCLUSIONS
  WDTC is associated with a significant recurrence rate but good disease-specific survival. The most important prognostic factors are family history of WDTC, extent of surgical treatment (i.e., total thyroidectomy), and advanced initial stage of disease, with a trend for age 60 years and older.
authors.affiliation: Department of Otolaryngology, Mount Sinai Hospital, 600 University Avenue, Toronto, Ontario, Canada M5G 1X5.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Cushing
authors.forename: Carsten E
authors.initials: CE
authors.lastname: Palme
authors.forename: Nathalie
authors.initials: N
authors.lastname: Audet
authors.forename: Spiro
authors.initials: S
authors.lastname: Eski
authors.forename: Paul G
authors.initials: PG
authors.lastname: Walfish
authors.forename: Jeremy L
authors.initials: JL
authors.lastname: Freeman
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001707:Biopsy, Needle; D018265:Carcinoma, Papillary, Follicular / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009864:Ontario; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods; D016896:Treatment Outcome