[Prognostic factors of differentiated thyroid cancers. 536 cases]. / Les éléments du pronostic des cancers thyroïdiens différenciés. 536 observations.

ABSTRACT

Five hundred thirty-six patients with papillary (n = 327) or follicular (n = 209) carcinoma of the thyroid treated between 1957 and 1985 in the same endocrine department are presented. Treatment was either an unilateral extracapsular lobectomy with isthmectomy, for isolated nodules only (n = 253), or a total thyroidectomy - with or without radio-iodine administration - or, exceptionally, a partial thyroidectomy. The impact of histologic type, age and sex of the patients, type of presentation and limited surgery (i.e. unilateral lobectomy in nodular carcinoma) were tested for prognostic value (total or relapse-free survival). The main factors are initial tumour extension (almost no survival after 10 years in case of metastasis; 87.98 +/- 0.04% 20 years estimate of percent surviving in exclusive thyroid localization); histologic type (relative death rate predominant papillary 0.28, follicular well differentiated 0.88, moderately differentiated 2.54 (p less than 0.01); age (prognosis as better as the patient is younger); sex (worse prognosis for men above 40 years). Unilateral lobectomy is an unhazardous treatment with a survival rate 92.41 +/- 0.03% at 20 years for follicular and papillary nodular carcinoma.