Immediate causes of death in thyroid carcinoma: Clinicopathological analysis of 161 fatal cases

Most patients with thyroid carcinoma have a good prognosis. Due to the smal l number of fatal cases, it has not been clarified what conditions result i n death for patients with thyroid carcinoma. To provide appropriate managem ent for advanced thyroid carcinoma patients, we analyzed causes of death in 161 fatal cases. Clinical characteristics and immediate (final) causes of death based on pathological conditions were analyzed in 62 anaplastic carci nomas and 99 fatal differentiated carcinomas. Single fatal conditions could not be specified in 55 patients. In the remaining 106 patients, respirator y insufficiency (43%) was the most common specific fatal condition, followe d by circulatory failure (15%), hemorrhage (15%), and airway obstruction (1 3%). Respiratory insufficiency due to remarkable pulmonary metastasis repla cing lung tissue, massive hemorrhage and airway obstruction due to uncontro lled local tumors, and circulatory failure resulting from compression of th e vena cava by extensive mediastinal or sternal metastases were found to be the most important immediate causes of death. Based on this knowledge, sev eral palliative procedures may be worth considering to improve survival and quality of life in patients with advanced thyroid carcinoma.