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. 2022 Mar 30;12(4):866.
doi: 10.3390/diagnostics12040866.

Long-Term Outcome of Differentiated Thyroid Cancer Patients-Fifty Years of Croatian Thyroid Disease Referral Centre Experience

Tomislav Jukić  1   2   3 , Ivan Blažeković  1 , Maja Franceschi  1   3 , Petra Petranović Ovčariček  1 , Marija Bosak Butković  1 , Nina Dabelić  1 , Roko Granić  1 , Marija Punda  1 , Zdenko Sonicki  2   4 , Davor Vagić  2   5   6 , Ana Fröbe  1   6 , Zvonko Kusić  7
Affiliations

Long-Term Outcome of Differentiated Thyroid Cancer Patients-Fifty Years of Croatian Thyroid Disease Referral Centre Experience

Tomislav Jukić et al. Diagnostics (Basel). .

Abstract

Background: Indolent nature but a high incidence of differentiated thyroid cancer (DTC) remains a challenge for optimizing patient care. Therefore, prognostic factors present valuable information for determining an adequate clinical approach. Methods: This study assessed prognostic features of 1167 papillary (PTC) and 215 follicular (FTC) thyroid cancer patients that had undergone surgery between 1962 and 2012, and were followed-up up to 50 years in a single institution, till April 2020. Age, gender, tumor size, presence of local and distant metastases at presentation, extrathyroidal extension, disease recurrence, and cancer-specific survival were evaluated. Results: In multivariate analysis, factors affecting the worse outcome were age (p = 0.005), tumor size (p = 0.006), and distant metastases (p = 0.001) in PTC, while extrathyroidal extension (p < 0.001), neck recurrence (p = 0.002), and distant metastases (p < 0.001) in FTC patients. Loco-regional recurrence rate was 6% for PTC and 4.7% for FTC patients, while distant metastases were detected in 4.2% PTC and 14.4% of FTC patients. The 10-year cancer-specific survival rates for PTC and FTC were 98.6% and 89.8%, respectively (p < 0.001). Conclusions: Negative prognostic factors, besides distant metastases, were older age and greater tumor size in PTC, and extrathyroidal extension and neck recurrence in FTC patients. The recurrence and mortality rates were very low.

Keywords: differentiated thyroid cancer; follicular; follow-up; papillary; prognostic features; recurrence; survival rates.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Cumulative events for local recurrence of PTC and FTC.
Figure 2
Figure 2
Cumulative events for new distant metastases of PTC and FTC.
Figure 3
Figure 3
Distant metastases of PTC and FTC in percentage (%) and number according to the site of metastasis.
Figure 4
Figure 4
Survival curves for PTC and FTC patients based on Kaplan–Meier estimates.
Figure 5
Figure 5
Cumulative death events (hazard) for PTC and FTC patients.
Figure 6
Figure 6
Cancer-specific survival of 1167 patients with PTC by the AJCC/UICC TNM staging system (8th edition) based on Kaplan–Meier estimates.
Figure 7
Figure 7
Cumulative events for local recurrence in 1167 patients with PTC by the AJCC/UICC TNM staging system (8th edition).
See this image and copyright information in PMC

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