Abstract
Objectives The aim of our study was to evaluate the survival rate of all thyroid carcinomas (TCs) diagnosed in the 1999-2015 period in the Republic of North Macedonia and to analyze the prognostic influence of several characteristics on development of distant metastases, as well as to analyze the prognostic effect of seven clinical and constitutional features on mortality. Material and methods A retrospective analysis of medical data from all TCs diagnosed in 1999-2015 was performed. The survival rate of all types of TCs was estimated using the Kaplan Meier method. Univariate and multivariate logistic regression analysis was applied for evaluation of the predictive role of seven clinical and constitutional characteristics for development of distant metastases, and the univariate Cox-proportional model was applied for evaluation of the predictors for mortality. Results A total of 422 TC cases were diagnosed in the 17-year period, with an average survival time of 212.99 months. Results of the univariate regression analysis showed that dimension at initial ultrasound and histopathological type of tumor were significantly predictive variables for distant metastases. Multifocal tumors vs. unifocal tumors < 15 mm significantly increased the probability of distant metastases by 7.401 (p = 0.005, 95% CI = 1.817-30.190) times. Age, initial lymph node involvement, number of radioiodine therapies, and histopathology of the tumor were selected as independent significant predictors for mortality. Conclusion Our results showed an excellent overall prognosis of thyroid tumors in the Macedonian population. The dimension of the tumor, multifocality, and histopathological type were the most relevant prognostic predictive features for development of distant metastases.
Highlights
Thyroid carcinomas (TCs) usually arise from follicular epithelial cells
We found appropriate data for evaluation of distant metastases in half of the TC patients (218/422; 51.66%), of which 70 (32.11%) had metastatic disease (Table 1)
We evaluated seven parameters to understand the possible implications in their predictive role for development of distant metastases and mortality of TCs in the Macedonian population over the analyzed period
Summary
Thyroid carcinomas (TCs) usually arise from follicular epithelial cells. There are three main groups of TCs: welldifferentiated (DTCs), poorly differentiated (PDTCs), and undifferentiated or anaplastic TCs (ATCs). Great diversity exists even in the PTC group, consisting of several subtypes according to distinct histopathological features, genetic molecular findings, aggressiveness, and prognosis [1,2,3,4,5,6]. FTC is the second most common TC, and according to the WHO classification is characterized by relatively well-differentiated cancer cells and absence of typical nuclear features of PTC [9,10,11,12,13]
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