Sex-specific differences in patients with differentiated thyroid carcinoma and their possible impact on survival.

PURPOSE: This study aimed to analyze survival outcomes in patients with differentiated thyroid cancer (DTC) compared to the general population, with particular focus on sex distribution, UICC staging, and age-specific mortality patterns. METHODS: A retrospective survival analysis was conducted on 3186 DTC patients with extended follow-up. Overall survival (OS) and relative survival (RS; observed survival in patients/expected survival in population) were compared to age- and sex-matched general population data, using Monte-Carlo simulation. Multivariate Cox regression analysis was performed to identify independent prognostic factors. RESULTS: Female predominance was confirmed in younger age groups with balanced distribution in the 40- to < 55-year cohort. DTC patients demonstrated superior OS compared to the general population, with improving RS over time. Female patients showed better survival outcomes than males and exceeded general population survival, while male patients achieved comparable survival. UICC stage I showed significantly lower mortality than all other stages. Only stage IVb consistently demonstrated worse outcomes than the general population. All age groups showed equal to superior survival compared to the general population, with patients ≥ 55 years demonstrating significantly improved RS from 5 years onward. Multivariate analysis identified sex, age at diagnosis, and UICC stage as independent prognostic factors for death. CONCLUSION: This analysis confirms generally favorable prognosis for DTC patients, demonstrating superior survival compared to the general population, due to increased health consciousness but also reflects the highly effective therapeutic regimen. Only patients ≥ 55 years with distant metastases (UICC stage IVb) consistently showed worse survival than the general population, emphasizing the critical importance of preventing disease progression.