Long-Term Survival Analysis and Prognostic Factors of Arabic Patients with Differentiated Thyroid Carcinoma: A 20-Year Observational Study at the King Hussein Cancer Center (KHCC) Involving 528 Patients

The impact of ethnic and geographic variation on observed differentiated thyroid cancer (DTC) outcomes has been well-documented, demonstrating distinct and disparate observations across different countries. However, there remains a paucity of evidence regarding the analysis of factors influencing DTC outcomes, specifically within the Arabic population. This study examines the long-term outcome of DTC in the Arab population, looking at various influential factors. The analysis of 528 cases revealed favorable survival outcomes. Disease progression was observed in a subset of cases, but the majority of patients achieved positive outcomes. Age at diagnosis, gender, risk categorization, and tumor stage impact both disease progression and mortality. The survival rates were favorable for patients who received RAI treatment. Moreover, adherence to institutional clinical practice guidelines (CPG) resulted in better disease control. Our study features the largest Middle Eastern and Arab cohort to date, highlighting the long-term favorable outcomes of DTC patients. DTC accounts for the majority of endocrine tumors. While the incidence of thyroid cancer has been increasing globally over the past few decades, papillary thyroid carcinoma (PTC) generally shows an excellent prognosis, except in cases with aggressive clinicopathological features. This study aimed to assess the 5- and 10-year overall survival (OS) and progression-free survival (PFS) of 528 Arabic patients diagnosed with primary DTC from 1998 to 2021. Additionally, the study aimed to analyze the impact of various factors on both OS and PFS. An univariable survival analysis was conducted using Kaplan-Meier curves. The 5- and 10-year OS for patients with DTC have exceeded 95%. Additionally, PFS showed very good rates (ranging between 96.5 and 85% at 5 and 10 years, respectively). Age, male gender, risk of recurrence, and distant metastasis were identified as the main negative prognostic factors for both OS and PFS, while RAI treatment was found to be a significant factor in improving OS. Moreover, adherence to the King Hussein Cancer Center's (KHCC) CPG demonstrated significant improvement in PFS. These findings highlight common prognostic factors and favorable outcomes in Arabic patients with DTC treated at a tertiary cancer center using standard of care approaches.