Follicular thyroid cancer natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]
Overview
Depending on the extent of the tumor at the time of diagnosis, the prognosis of follicular thyroid cancer may vary. However, the prognosis is generally regarded as good. The presence of metastasis is associated with a particularly poor prognosis among patients with follicular thyroid cancer.
Natural History
The natural history of follicular thyroid cancer is variable. The symptoms of follicular thyroid cancer usually develop in the fourth decade of life, and start with symptoms such as a slowly enlarging painless mass. Without treatment, the patient will develop symptoms of compression and metastasis such as hoarseness of voice, dysphagia, and dyspnea.[1]
Complications
Prognosis
- Prognosis of follicular thyroid cancer is directly related to tumor size.
Worst Prognostic Factors
- Women older than 50 with follicular carcinoma
- Men older than 40 with follicular carcinoma
- Distant metastasis
- Large tumor size
- Extensive vascular invasion
- Extra thyroidal extension
- Widely invasive tumors
Good Prognostic Factors
- Children
- Adolescent
- Women younger than 50
- Men younger than 40
- While follicular cancer has a good prognosis, it is less favorable than that of papillary carcinoma. The 10-year survival is better for patients with follicular carcinoma without vascular invasion than it is for patients with vascular invasion.
- Follicular carcinoma invading cervical tissue has a worse prognosis than tumors confined to the thyroid gland. The presence of vascular invasion is an additional poor prognostic factor. Metastases to lymph nodes do not worsen the prognosis in patients younger than 45 years.
- The prognosis for patients with distant metastases is poor.
5 year Relative Survival Rate
- 5 year relative survival rate of follicular thyroid cancer depends on the stage of the disease at the time of diagnosis.
- Stage 1 has 100% 5 year relative survival rate
- Stage 2 has 100% 5 year relative survival rate
- Stage 3 has 71% 5 year relative survival rate
- Stage 4 has 50% 5 year relative survival rate
References
- ↑ Thyroid Cancer Cancer.gov (2015). http://www.cancer.gov/types/thyroid/hp/thyroid-treatment-pdq#section/_6- Accessed on October, 29 2015