FACTORS AFFECTING THE PROGNOSIS OF PATIENTS WITH CARCINOMA OF THE THYROID

Abstract

Of 763 patients with carcinoma of the thyroid who had undergone a primary operation between 1948 and 1970, 705 were observed for more than 5 yr. Included were 545 patients with papillary carcinoma, 123 with follicular carcinoma, 59 with microcancer, 30 with undifferentiated carcinoma and 6 with medullary carcinoma. The relative survival rate for patients with pure undifferentiated carcinoma 1 yr after operation was 27% and that for those with mixed undifferentiated carcinoma was 24%. For patients with differentiated carcinomas, the most important factors affecting the prognosis were age and sex. The 15 yr survival rates for women less than 40 yr of age with papillary or follicular carcinoma were 102 and 100%, respectively, while for women more than 40 yr with papillary or follicular carcinoma, they were 90 and 84%, respectively. For men more than 40 yr of age with papillary carcinoma, the relative survival rate was 67%. The size of the tumor and the types of operation did not affect the prognosis in patients less than 40 yr. The presence of chronic thyroiditis also had no effect upon the prognosis. The relative survival rate with tumors up to 99 g in weight, after 20 yr, was almost 100% in women less than 40 yr of age, while for women more than 40 yr of age, the survival rates were 95% with tumors weighing less than 20 g and 72% with those weighing 20-99 g, an indication that tumor size may affect prognosis in older patients.