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  • Title: Prognostic factors in follicular carcinoma of the thyroid: a study of 198 cases.
    Author: Rao RS, Parikh HK, Deshmane VH, Parikh DM, Shrikhande SS, Havaldar R.
    Journal: Head Neck; 1996; 18(2):118-24; discussion 124-6. PubMed ID: 8647676.
    Abstract:
    BACKGROUND: Prognostic parameters for papillary carcinoma of the thyroid have been defined by several groups. However, no such study has been reported for follicular carcinoma. METHODS: We undertook a retrospective study of well-differentiated carcinoma of the thyroid operated at the Tata Memorial Hospital during the period 1970-1985. In our series, follicular carcinoma formed 48% of the well-differentiated carcinomas of the thyroid. The variables age, sex, size, extrathyroidal spread, distant metastases, and lymph node metastases were evaluated. The survival was plotted according to the Kaplan-Meier method, and graphs compared by log-rank test. Univariate and multivariate analyses were performed. RESULTS: Based on our experience we stratified the cases into low-risk and high-risk groups. The low-risk group included: age below 40 years, tumor size less than 5 cm. and no extrathyroidal extension or metastases. This low risk group had 100% survival at 15 years, compared with 40% survival for the high-risk group (P <.001). Seventy-three percent (73%) of our cases were in the high-risk group. CONCLUSIONS: Based on our findings that the majority of our patients were in the high-risk group, we advocate a total or near-total thyroidectomy in treatment of follicular carcinoma of the thyroid. There is a need to arrive at a universally acceptable classification of risk groups in follicular carcinoma of the thyroid gland.
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