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Endocrine Abstracts (2002) 3 S20

BES2002 Symposia Differentiated Thyroid Cancer (4 abstracts)

Differentiated Thyroid Cancer (DTC): Treatment Outcomes

EL Mazzaferri


The University of Florida, 1600 SW Archer Road, P.O. Box 100226, Gainesville, FL 32610-0226, USA


Outcomes with DTC measured in terms of cancer-specific mortality, tumor recurrence and disease-free survival rates give different views of the efficacy of treatment. In our cohort of 1528 patients (median age 34 yr, range 5-91 yr) after a median follow-up of 16.6 yr, 40-yr cancer-specific mortality was 8% and recurrence rate was 37%. A delay in treatment of 12 months or more significantly increased the 40-yr cancer-specific mortality (6.6% vs 13.5%, P=0.002). Treatment variables (in addition to other variables) that independently influenced outcome (Cox analysis) are shown in the table.

VariableHR P95%CI
All Cancer Recurrence N=1,501
Thyroid remnant 131I ablation0.8.0160.7 - 0.97
Therapy with 131I0.5.00010.4 - 0.6
Surgery more than lobectomy0.7.00010.6 - 0.9
Distant Metastasis Recurrence N=1501
Thyroid remnant 131I ablation0.6.0020.5 - 0.8
Therapy with 131I0.4.00010.2 - 0.6
Surgery more than lobectomy0.8.3790.6 - 1.2
Cancer Mortality N=1501
Thyroid remnant 131I ablation0.5.00010.4 - 0.7
Surgery more than lobectomy0.5.00010.4 - 0.7
Therapy with 131I0.4.0100.2 - 0.8

Clinical staging systems that employ age often fail to identify patients who are at risk of a poor outcome. When the AMES staging system was applied to our cohort, for example, 84% of the tumor recurrences, 78% of the distant recurrences and 48% of the cancer deaths were in the group categorized as being at low-risk. Optimal treatment of patients with DTC is near-total thyroidectomy and 131 I ablation.

Volume 3

21st Joint Meeting of the British Endocrine Societies

British Endocrine Societies 

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