Prognostic factors in follicular carcinoma of the thyroid: A study of 198 cases




Prognostic parameters for papillary carcinoma of the thyroid have been defined by several groups. However, no such study has been reported for follicular carcinoma.


We undertook a retrospective study of well-differentiated carcinoma of the thyroid operated at the Tata Memorial Hospital during the period 1970–1985. In our series, follicular carcinoma formed 48% of the well-differentiated carcinomas of the thyroid. The variables age, sex, size, extrathyroidal spread, distant metastases, and lymph node metastases were evaluated. The survival was plotted according to the Kaplan-Meier method, and graphs compared by log-rank test. Univariate and multivariate analyses were performed.


Based on our experience we stratified the cases into low-risk and high-risk groups. The low-risk group included: age below 40 years, tumor size less than 5 cm, and no extrathyroidal extension or metastases. This low risk group had 100% survival at 15 years, compared with 40% survival for the high-risk group (P < .001). Seventy-three percent (73%) of our cases were in the high-risk group.


Based on our findings that the majority of our patients were in the high-risk group, we advocate a total or near-total thyroidectomy in treatment of follicular carcinoma of the thyroid. There is a need to arrive at a universally acceptable classification of risk groups in follicular carcinoma of the thyroid gland. HEAD & NECK 1996;18:118–126 © 1996 John Wiley & Sons, Inc.