PROGNOSTIC FACTORS IN PATIENTS WITH RECURRENT DIFFERENTIATED THYROID-CARCINOMA

Background: Approximately 20% of patients with thyroid carcinoma have relapse. To evaluate the factors affecting their disease-free survival and prognosis, we studied 68 patients with recurrent differentiated t hyroid carcinoma, ranging in age from 5 to 73 years (mean: 47.6 years) . Three-fourths of patients were followed for >10 years. Thirty-nine p atients were treated with total or subtotal thyroidectomy at first ope ration; the remainder underwent lesser operations. Fifty-six patients had local recurrence, mostly lymph node infiltration. Twenty-six patie nts died. Methods: Survival curves were constructed using the Kaplan-M eier method. Factors affecting relapse and survival were tested by uni variate or multivariate analysis. Results: Univariate analysis identif ied age at diagnosis, local tumor extension, and surgical method as si gnificant factors for disease-free survival. These three factors and h istology were significant prognostic factors. Multivariate analysis sh owed age, histology, and disease-free interval as significant and inde pendent variables. Conclusions: In high-risk patients, complete resect ion of thyroid tissue and cervical lymph nodes is critical. (C) 1997 W iley-Liss, Inc.