[15 years' results in the treatment of differentiated thyroid carcinoma in a region of endemic goiter].

We have evaluated the results of differentiated thyroid carcinoma treatment after 15 years of follow up. The group consisted of 120 cases of papillary type and 144 cases of follicular type; the mean age of the patients was 38.2 years for papillary and 46.5 for the follicular. The ratio men/women was 1/4 for the papillary and 1/3.2 for the follicular. The prognostic factors evaluated included: a) histologic types according to WHO classification, b) clinical stage, c) age and d) sex. The staging of the disease followed the classification suggested by Smendal, stage I: intraglandular disease; stage II: regional lymph node metastases; stage III: invasion of other tissues in the neck or mediastinum and stage IV: distant metastases. The basic treatment was surgery with the use of 131I and thyroid hormone. The results were statistically analyzed with the conventional life table method or chi square. At 15 years the overall survival was 84 +/- 4% for the papillary type and 66 +/- 9% for the follicular type (p = 0.01) (Fig. 1). The patients treated in stage I had a survival of 90 +/- 5%, significantly higher than those in stage II (53 +/- 8%), p less than 0.03. In stage III and IV the small number of patients made it difficult to interpret the results statistically (Fig. 2). The age of the patients appears to be another prognostic factor. The group under 40 years had 85 +/- 5% of survival compared to 59 +/- 4% over 40 years, p less than 0.01 (Fig. 3).(ABSTRACT TRUNCATED AT 250 WORDS)