Surgically incurable well-differentiated thyroid carcinoma. Prognostic factors and results of therapy

R. L. Rossi, B. Cady, M. L. Silverman, M. S. Wool, S. G. ReMine, M. B. Hodge and F. A. Salzman
Department of Surgery, Lahey Clinic Medical Center, Burlington, MA 01805.

A series of 97 consecutive patients with well-differentiated thyroid carcinoma treated between 1941 and 1970 presented with distant metastatic disease or extensive nonresectable local neck disease or had residual carcinoma after thyroid resection. Men 40 years of age or younger and women 50 years of age or younger were considered at low risk for dying of disease; older patients were considered at high risk for dying of disease. Of 17 patients with distant metastatic carcinoma, 40% of younger patients in the low-risk group and 92% of older patients in the high-risk group died. Of 80 patients with unresectable or residual local neck cancer, only 13% of younger patients but 71% of older patients died. Survival related better to risk group classification as defined by age and sex than to any details of disease presentation or management. Treatment was far more successful in patients in the low-risk group.