title: Early death from papillary thyroid carcinoma.
abstract: OBJECTIVE
  The natural history of papillary thyroid carcinoma (PTC) is characterized by a slow growth rate and an excellent prognosis at 20 and 30 years. However, there is a small subset of patients with poorer outcome.
  
  
  METHODS
  Twenty patients who died of PTC within 10 years of diagnosis were studied to identify prognostic indicators and biological markers of early death. Findings were statistically compared with a previous review of all patients with PTC treated in the same institute and studies in the literature.
  
  
  RESULTS
  The study group included 6 men and 14 women with a mean age of 65 years at diagnosis. Average tumor size was 3.6 cm; 16 patients had extracapsular extension. All tumor samples studied histologically stained poorly for p53, Ki67, and CD34. Regional metastases were present in half the patients, and distal metastases in all. All patients had an advanced disease stage (Tumor, Node, Metastases classification), and only 4 had a low score on the Metastases, Age, Completeness of resection, local Invasion, tumor Size risk stratification. Analysis of the findings against data in the literature for the whole population of patients with PTC, who had a considerably better survival (<8% mortality within 8-15 years vs 100% within 10 years in our sample), yielded significant differences for rates of extrathyroidal extension (P = .0001), regional metastases (P = .016), and distant metastases (P = .0001).
  
  
  CONCLUSIONS
  Extrathyroid extension, late regional metastases, and distant metastases may be risk factors for early death from PTC.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petah Tiqwa, Israel. yhamzany@gmail.com
authors.forename: Yaniv
authors.initials: Y
authors.lastname: Hamzany
authors.forename: Ethan
authors.initials: E
authors.lastname: Soudry
authors.forename: Yulia
authors.initials: Y
authors.lastname: Strenov
authors.forename: Noga
authors.initials: N
authors.lastname: Lipschitz
authors.forename: Karl
authors.initials: K
authors.lastname: Segal
authors.forename: Tuvia
authors.initials: T
authors.lastname: Hadar
authors.forename: Ohad
authors.initials: O
authors.lastname: Hilly
authors.forename: Raphael
authors.initials: R
authors.lastname: Feinmesser
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D002277:Carcinoma; D002291:Carcinoma, Papillary; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy
chemical_list: D014408:Biomarkers, Tumor