Survival rate of patients with differentiated thyroid cancer without early postoperative external radiation of the neck

Results of survival rates in differentiated thyroid carcinoma and comparison with a review of literature are given. Four hundred and sixty-four patients with differentiated cancer of the thyroid (354 female, 110 male, range: 6 to 84 years, median: 46.8 years; 275 patients with papillary and 190 with follicular cancer) were analyzed retrospectively. All patients were treated with ablative doses of radioiodine after thyroidectomy including compartment oriented lymphadenectomy in 27 patients. All patients passed an individual systematic follow-up according to risk: 'Low risk' pT≤3NxM0 vs. 'high risk' pT4 and/or M1. Early postoperative radiation was not included even in patients with local invasion (pT4). The corrected 5- and 10-year survival rates for papillary cancer are 0.91 and 0.91, for follicular cancer 0.94 resp. 0.78 (p=0.55), age (≤40 years 0.96 and 0.96, >40 years 0.90 and 0.80; p=0.008), gender (female 0.93 and 0.92, male 0.90 and 0.70; p=0.06) and invasion/distant metastases (pT4 and/or M1 0.83 and 0.71, other 0.97 and 0.97; p=0.0001). A systematic follow-up with an individually adapted standardized scheme is associated with high survival rates in patients with differentiated cancer of the thyroid. Early diagnosis of recurrences, locoregional lymph node and distant metastases with early surgical treatment including compartment oriented lymphadenectomy and radioiodine therapy yield high survival even without external radiation. (orig./MG)