PROGNOSTIC FACTORS FOR THYROID-CARCINOMA - A POPULATION-BASED STUDY OF 15,698 CASES FROM THE SURVEILLANCE, EPIDEMIOLOGY AND END RESULTS (SEER) PROGRAM 1973-1991

BACKGROUND. A number of prognostic factors for thyroid carcinoma have been identified, including sociodemographic characteristics, such as a ge and gender, and tumor characteristics, such as histology and stage, The relative importance of these factors as independent predictors of survival for patients with papillary follicular, anaplastic, and medu llary thyroid carcinoma has been extensively studied but remains uncer tain. METHODS, The authors used data collected by tile Surveillance, E pidemiology and End Results (SEER) program of the National Cancer Inst itute between 1973 and 1991 to investigate prognostic factors for each of the major histologic types of thyroid carcinoma in a population-ba sed patient series and to assess the effect of these factors as predic tors of survival. RESULTS, Both tumor and sociodemographic characteris tics were independently associated with survival. Patients with papill ary carcinoma had the highest 10-year relative survival (0.98), follow ed by; those with follicular carcinoma (0.92) and medullary carcinoma (0.80). Anaplastic tumors had the lowest 10-year relative survival (0. 13). Stage at diagnosis and differentiation status were strong indepen dent prognostic factors for each histologic type. Advanced stage at di agnosis was a stronger prognostic factor for medullary carcinoma than For other histologic types. Increasing age was associated with lower r elative survival for each histologic type. Gender, marital status, and ethnicity were significant, but weaker, predictors of survival. CONCL USIONS. Survival varied markedly among patients with different histolo gic types of thyroid carcinoma. Stage at diagnosis and tumor different iation were important prognostic factors for each histologic type. Age at diagnosis was a stronger predictor of survival for patients with f ollicular and medullary carcinoma than for patients with papillary car cinoma. (C) 1997 American Cancer Society.