Journal of Clinical Endocrinology & Metabolism, Vol 80, 2946-2953, Copyright © 1995 by Endocrine Society

ARTICLES

Morbidity and mortality in follicular thyroid cancer

LJ DeGroot, EL Kaplan, MS Shukla, G Salti and FH Straus
Department of Medicine, University of Chicago, Illinois 60637, USA.

The natural history and results of treatment have been analyzed in a group of 49 patients with follicular thyroid carcinoma who were followed for an average of 10.7 yr. Striking differences between the course of follicular thyroid carcinoma and the course of papillary carcinoma are evident. Deaths from cancer were double (16% for follicular), age at diagnosis was older, and age at death was younger. All deaths and recurrences happened within 13 yr, in contrast to the continued experience of deaths and recurrences in papillary cancer, even through 40 yr of observation. Adverse outcome correlated with extent of disease at diagnosis and with size of primary tumor, but did not correlate with vessel invasion, extent of capsule invasion, degree of dedifferentiation, extent of primary surgery, or radioactive iodide ablation. These observations are again in striking contrast to experience with papillary cancer. No patient with intrathyroidal disease who was under age 45 at diagnosis and with a primary tumor of less than 2.5 cm died. Our observations suggest that follicular cancer, even if apparently intrathyroidal, carries a high mortality rate in patients over age 45 or in those with tumors larger than 2.5 cm at the time of diagnosis and suggest that we must consider additional therapeutic measures in this group of patients, including larger radioiodine doses for initial therapy, external radiotherapy, and even possibly prophylactic chemotherapy.

This article has been cited by other articles:

				R. Sciuto, L. Romano, S. Rea, F. Marandino, I. Sperduti, and C. L. Maini Natural history and clinical outcome of differentiated thyroid carcinoma: a retrospective analysis of 1503 patients treated at a single institution Ann. Onc., October 1, 2009; 20(10): 1728 - 1735. [Abstract] [Full Text] [PDF]

				F. A Verburg, U. Mader, M. Luster, and C. Reiners Histology does not influence prognosis in differentiated thyroid carcinoma when accounting for age, tumour diameter, invasive growth and metastases Eur. J. Endocrinol., April 1, 2009; 160(4): 619 - 624. [Abstract] [Full Text] [PDF]

				B. H.-H. Lang, C.-Y. Lo, W.-F. Chan, K.-Y. Lam, and K.-Y. Wan Staging systems for follicular thyroid carcinoma: application to 171 consecutive patients treated in a tertiary referral centre Endocr. Relat. Cancer, March 1, 2007; 14(1): 29 - 42. [Abstract] [Full Text] [PDF]

				C. F. A. Eustatia-Rutten, E. P. M. Corssmit, N. R. Biermasz, A. M. Pereira, J. A. Romijn, and J. W. Smit Survival and Death Causes in Differentiated Thyroid Carcinoma J. Clin. Endocrinol. Metab., January 1, 2006; 91(1): 313 - 319. [Abstract] [Full Text] [PDF]

				C. Ma, J. Xie, and A. Kuang Is Empiric 131I Therapy Justified for Patients with Positive Thyroglobulin and Negative 131I Whole-Body Scanning Results? J. Nucl. Med., July 1, 2005; 46(7): 1164 - 1170. [Abstract] [Full Text] [PDF]

				M. N. Younes, O. G. Yigitbasi, Y. W. Park, S.-J. Kim, S. A. Jasser, V. S. Hawthorne, Y. D. Yazici, M. Mandal, B. N. Bekele, C. D. Bucana, et al. Antivascular Therapy of Human Follicular Thyroid Cancer Experimental Bone Metastasis by Blockade of Epidermal Growth Factor Receptor and Vascular Growth Factor Receptor Phosphorylation Cancer Res., June 1, 2005; 65(11): 4716 - 4727. [Abstract] [Full Text] [PDF]

				A. M. Sawka, K. Thephamongkhol, M. Brouwers, L. Thabane, G. Browman, and H. C. Gerstein A Systematic Review and Metaanalysis of the Effectiveness of Radioactive Iodine Remnant Ablation for Well-Differentiated Thyroid Cancer J. Clin. Endocrinol. Metab., August 1, 2004; 89(8): 3668 - 3676. [Abstract] [Full Text] [PDF]

				N. Wada, Q.-Y. Duh, D. Miura, L. Brunaud, M. G. Wong, and O. H. Clark Chromosomal Aberrations by Comparative Genomic Hybridization in Hurthle Cell Thyroid Carcinomas Are Associated with Tumor Recurrence J. Clin. Endocrinol. Metab., October 1, 2002; 87(10): 4595 - 4601. [Abstract] [Full Text] [PDF]

				A. Sevinc, S. Buyukberber, R. Sari, T. Baysal, and B. Mizrak Follicular Thyroid Cancer Presenting Initially with Soft Tissue Metastasis Jpn. J. Clin. Oncol., January 1, 2000; 30(1): 27 - 29. [Abstract] [Full Text] [PDF]

				M. Schlumberger Use of Radioactive Iodine in Patients with Papillary and Follicular Thyroid Cancer: Towards A Selective Approach J. Clin. Endocrinol. Metab., December 1, 1998; 83(12): 4201 - 4203. [Full Text]