Prognostic factors determining survival in patients with node positive differentiated thyroid cancer: a retrospective cross-sectional study

Objective The prognostic factors for the disease-free status and overall survival among patients who had differentiated thyroid cancer with cervical lymph node metastasis were evaluated to develop a better understanding of the possible effects of lymph node metastasis on the disease process. Design The data from 101 patients who underwent modified radical neck dissection to determine the presence of cervical node positive differentiated thyroid cancer was evaluated and disease-free survival and overall survival rates were calculated. Prognostic factors predicting these survival rates were evaluated. Setting This research took place between July of 1994 and December of 2006 in the Department of General Surgery at Ankara Oncology Training and Research Hospital. Participants One hundred and one patients underwent a modified radical neck dissection after the cervical nodes were assessed as positive for the presence of cancer. Main Outcome Measures Ten-year disease-free survival and overall survival rates were measured. Results We calculated the 10-year disease-free survival rate at 67.3% and the overall survival rate at 86.1%. Age, thyroidal extracapsular invasion, vascular invasion, metastasis, age, completeness of resection, size score and TNM staging were found to be relevant to disease-free survival and overall survival in both the univariate and the multivariate analyses. While the age, metastasis, extent of disease score was relevant to disease-free survival and overall survival in the univariate analysis, this association is not found in the multivariate analysis. The histological type of the tumour was not predictive of disease-free survival, but the follicular type was closely related to the prognosis for overall survival. Conclusion Cervical node metastasis in thyroid carcinoma slightly reduces overall survival. Prognostic factors can help identify high-risk patients and point towards an adequate therapeutic approach.