PROGNOSTIC FACTORS IN DIFFERENTIATED THYROID-CARCINOMA - A MULTIVARIATE-ANALYSIS OF 234 CONSECUTIVE PATIENTS

Background and Objectives: The clinical characteristics and patient ou tcome of a group of patients treated for differentiated thyroid carcin oma (DTC) were analyzed in order to assess the relative influence of d ifferent prognostic factors. Materials and Methods: We retrospectively reviewed data about sex, age, size and histologic behavior of the tum or, extrathyroid extension of the tumor, lymph node status, distant me tastasis at diagnosis, surgical procedures, and overall survival from 234 patients treated for DTC. Data were submitted to a statistical ana lysis. Results: Using a univariate analysis, we found that survival ra tes were significantly influenced by age (P = 0.0001), size (P = 0.018 ), extra thyroidal extension (P = 0.000001), lymph node involvement (P = 0.03), and distant metastases (P = 0.049). Age and size were indepe ndent prog prognostic factors at multivariate analysis (t = 2.694 and t = 2.443, respectively). Conclusions: On the basis of our results and of a review of the literature, we conclude that total thyroidectomy i s the treatment of choice in DTC, except for small (<1 cm) papillary c arcinoma, that could be treated by lobectomy plus isthmectomy, while l ymphadenectomy is indicated only in case of macroscopic involvement. J . Surg. Oncol. 1998;68:237-241. (C) 1998 Wiley-Liss, Inc.