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Abstract
Background. We have previously described prognostic factors in differentiated carcinoma of this
thyroid gland relating to age, size and extrathyroid extension of the tumor, histologic
grade, gender, and distant metastasis. These factors have identified patients in the
lozv-risk group with excellent prognosis and the high-risk group with significant
mortality. However, some patients fall within the intermediate-risk category where
due deliberation in decision making is required for selection of appropriate treatment.
Methods. A retrospective review of a consecutive series of 1038 previously untreated patients
with differentiated carcinoma of thyroid treated during a period of ,55 years was
undertaken. Data gathered from review of the charts were subjected to univariate and
multivariate analysis to assess prognostic factors. On the basis of the patient's
age, presence of distant metastasis, and size, grade, and histologic characteristics
of the tumor they could be classified into low-, intermediate-, and high-risk categories.
Thus 403 (39%) patients were in the low-risk group, 232 (22%) patient in the high-risk
category, and 403 (39%) patients in the intermediate-risk category.
Results. With a median follow-up of 20 years, 99% survival was achieved in the low-risk group,
whereas only 57% survived in the high-risk group. Interestingly, in the intermediate-risk-
category of 403 patients, the 20-year survival was only 85%, Our results clearly identify
a distinct intermediate-risk category that includes low-risk patients with high-risk
tumor or high-risk patients with low-risk tumor.
Conclusion. Patients in the intermediate-risk category should be considered for an aggressive
treatment approach based on individual prognostic factors.
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Article info
Footnotes
☆Presented at the Fifteenth Annual Meeting of the American Association of Endocrine Surgeons, Dearborn, Mich., April 17–19, 1994.
Identification
Copyright
© 1994 Published by Elsevier Inc.
