What is the prognosis of thyroid cancer?

Updated: May 09, 2018
  • Author: Pramod K Sharma, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

The long-term disease-free survival with aggressive treatment and management is nearly 90% overall. A variety of factors, as follow, are associated with prognosis:

  • Age: The patient's age at diagnosis is one of the most important prognostic features of well-differentiated thyroid carcinoma; cancer-related death is most likely to occur if the patient is >40 years at the time of diagnosis; recurrences are most common in patients whose disease is diagnosed when they were < 20 years or >60 years

  • Sex: Men are twice as likely as women to die from thyroid cancer

  • Size: The size of the primary tumor is related to survival; patients with primary tumors >4 cm have increased recurrence and cancer-related mortality rates (although a study by Nguyen et al indicated that no association exists between increasing tumor size and survival in patients with thyroid cancer until the tumor reaches dimensions of >2.5 cm [25] )

  • Histology: Overall, papillary carcinoma is associated a 30-year cancer-related death rate of 6%; follicular carcinoma has a 30-year cancer-related death rate of 15%

  • Local invasion: Invasion of surrounding tissues outside of thyroid indicates biologic aggressiveness and significantly worsens the patient's prognosis

  • Lymph node metastasis: Lymph node metastasis does not appear to be as important in the outcome of well-differentiated thyroid carcinomas as in the outcome of most other solid tumors

  • Distant metastasis: Distant metastasis at initial examination is associated with a 68.1-fold increase in the rate of disease-specific death

  • Socioeconomic factors: A study by Swegal et al indicated that socioeconomic factors affect survival in cases of well-differentiated thyroid cancer, with lower household income being associated with a higher disease-related death rate; the study included 1317 patients [26]


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