Endocrine Abstracts

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.

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.