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A Journal on Surgery

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Minerva Chirurgica 2001 December;56(6):583-92


language: Italian

Differentiated thyroid carcinoma. Prognosis and therapy

Parmeggiani U., De Falco M., Parmeggiani D., Giudicianni C.


Background. We have conducted retrospective analysis of 90 cases of Differentiated Thyroid Cancer (DTC) operated between 1978 and 1998. The aim of this study was to verify the most widely used prognostic factors and to try to identify differences in the development of these tumors.
Methods. The DTCs, selected from the histopathologic reports of the Institute of Pathologic Anatomy, were divided into high, intermediate and low malignancy tumors according to the classification of Carcangiu and Rosai.
Results. We found that age >45 years associated with a cancer larger than 1.5 cm and intermediate malignancy was related to the most dismal prognosis. Ten of the 90 cases had a dismal prognosis; 6/10 (60%) had disease recurrence. Four of those six patients died; one has disease recurrence 5 months after surgery, and one patient with disease recurrence after one year was lost to follow-up. The identification of metastases at the primary operation is of course an unfavourable prognostic factor. In fact, all of the six cases with metastases had disease recurrence after the treatment: three patients have died; two survive (one have a disease period of 5 months and the other a disease period of 2 years); one patient with disease recurrence one year after surgery was lost to follow-up.
Conclusions. The most significant negative factors for prognosis purposes were the higher degrees of T, the presence of metastases at diagnosis or their appearance at follow-up, age greater than 45, male sex and areas of dedifferentiation within the histological pattern. Total thyroidectomy remains the treatment of choice.

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