Abstract

Papillary thyroid cancer has the most favorable prognosis for patients. According to the recommendations of the National Comprehensive Cancer Network (NCCN), organ‑sparing surgery can be performed for such patients without radioactive iodine therapy (RIT). However, some factors, for example, vascular invasion, multifocality, the presence of regional metastases, etc. increase stratification risks for the patient and give the reason to perform more voluminous surgical interventions and conduct RIT. With differentiated thyroid cancer (DTC), the 5‑year and 10‑year overall survival rates reach 100% and 96%, respectively.
 Objective — to investigate the relationship between the pathohistological characteristics of the DTC tumor and distant metastasis.
 Materials and methods. The study involved 522 patients aged 4 to 79 years (the mean age 40.2±0.6 years) after previous thyroid cancer surgery and RIT. Patients were divided into two groups depending on the presence of distant metastases: 28 (5.4%) with distant metastases and 494 (94.6%) patients without distant metastases.
 Results. Using the data of pathohistological findings, both groups were compared according to the following criteria: pathomorphological DTC subtype, vascular invasion, other extraordinary invasion, multifocality, the size of the primary tumor, the size of the largest focus and the total size of foci for multifocal cancers, the number and maximum size of metastases in the central and lateral lymphatic collectors of the neck.
 Conclusions. No significant relationship has been found between the pathomorphological subtype of differentiated thyroid cancer, the presence of vascular and extra‑organ invasion, and the presence of distant metastases, but a relationship was found with multifocality. In the group of patients with distant metastases, a larger size of the primary focus, and a larger size and number of regional metastases were determined.

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