THYROID-CANCER OF PAPILLARY, FOLLICULAR, OR MIXED TYPES - DIFFERENCESIN CLINICAL OUTCOME AND PROGNOSTIC FACTORS BETWEEN WOMEN AND MEN

Background: The variation in the clinical development of thyroid cance r makes it necessary to determine prognostic factors in order to optim ize treatment. The aim of this study was to analyse the specific progn ostic risk factors in women and in men with respect to papillary, foll icular, or mixed thyroid cancer and also papillary and mixed groups to gether. Methods: Prognostic factors based upon 218 females and 91 male s were analysed. Patients were analysed according to histopathological type, age, gender, local tumour extent, regional lymph node and dista nt metastases, grade of differentiation, tumour-related symptoms at di agnosis adjusted for different treatments. These potential prognostic factors were compared by multivariate analysis, using the Cox semi par ametric hazard model. Survival rates were calculated by the Kaplan-Mei er method. Results: Four parameters had a significant effect in determ ining tumour relapse: age >50 years, male gender, moderate or low grad e of differentiation, and follicular type. When considering the risk o f tumour mortality, distant metastases, low or moderate differentiatio n, age >50 years, regional lymph node metastases, male gender, and fol licular type were significant independent, risk factors. Separate anal ysis of mortality risk revealed that tumour-related symptoms at diagno sis were a prognostic factor in men only. More radical treatments tend ed to be used in women. Conclusions: Differences in prognosis between women and men, with a higher relapse rate and mortality risk among men , were found in this study. In the treatment of papillary, follicular, or mixed thyroid cancer the prognostic factors for tumour relapse and mortality have to be considered.