Revista chilena de cirugía
versión ISSN 0718-4026
DOMINGUEZ E, Miguel et al. Prognostic factors study of differentiated thyroid cancer. Rev Chil Cir [online]. 2011, vol.63, n.6, pp. 566-572. ISSN 0718-4026. doi: 10.4067/S0718-40262011000600004.
The aim of this investigation was to evaluate the prognostic factors in patients with differentiated thyroid carcinoma treated and followed for a long period of time. Patients and Method: The following prognostic variables: gender, age at diagnosis, goiter characteristics, histology, differentiation grades, tumor anatomical extension, lymph node and distant initial metastasis and post treatment evolution were studied in a historical cohort of thyroid carcinoma. Surgical treatment was subtotal and total thyroidectomy plus lymphatic cervical selective neck dissection. Radioiodine was employed en 59.2% and thyroid hormone replacement was used indefinitely. Kaplan Meyer analisis was employed to plot survival curves, log Rank test was used to establish the significance of each variable and square chi to determine differences among groups. Cox model was used to identify prognostic variables. Results: A group of 477 patients with differentiated thyroid carcinoma treated at the Hospital San Juan de Dios, from 1948 to 1992, were studied. Median survival rate was 87% at the end of observation period. Univariate analysis showed significant differences for age, tumor anatomical extension and histological grade on survival, for the entire serie. According to Cox model method, initial distant metastasis, age > 40 years, anatomical extension, tumor size > 10 mm, were determinant for unfavorable prognosis for the papillary cancer; distant metastasis, anatomical extension and age at the time of diagnosis were determinant for unfavorable prognosis for the follicular cancer. Conclusion: Overall survival was 87%. Distant metastasis at the time of diagnosis: age older than 40 years, anatomical extension and the size of the tumor were determinant of survival prognosis.
Palabras clave : Differentiated thyroid cancer; survival rate; prognostic factors.