FATAL DIFFERENTIATED THYROID-CANCER

Thirty-five patients who died of differentiated thyroid cancer were an alyzed for factors affecting survival. The neck was the most common in itial site of recurrence (62.0%). The lung was the most common metasta tic site (56.7%). Major sites associated with death were locoregional recurrence (neck and mediastinum: 48.6%) and bone metastases (22.9%). By univariate analysis, local tumor extension, type of initial surgery , and residual tumor and/or existence of distant metastases at the ini tial operation were significant factors affecting survival. Stepwise m ultivariate analysis revealed that invasion of the esophagus and/or ca rotid artery shortened survival and that multiple surgeries extended s urvival. Our results suggest that to improve survival in patients with differentiated thyroid cancer, better locoregional control, including multiple surgical resection, is necessary. (C) 1996 Wiley-Liss, Inc.