Long-term follow-up and therapeutic results in patients with low-risk differentiated thyroid carcinoma

Aim and methods: A retrospective study was performed to determine the frequency of local recurrences and distant metastases as well as potential risk factors in patients with low-risk differentiated thyroid carcinoma. In addition, the efficiency of our follow-up programme and the diagnostic value of the procedures administered was to be evaluated. Results: 41/740 (8%) patients developed 62 recurrences at a mean 4.7 years after the onset of the disease. In 14 cases the tumormarker thyroglobulin was the first diagnostic sign, 13 recurrences were diagnosed by chest x-ray and/or CT. In 12 cases recurrences/ metastases were detected by iodine-131 whole body scan, and 8 cases by ultrasound of the neck. A good prognosis was found if patients were under 45 years of age when the tumor was first diagnosed, and if the tumor did not exceed 20 mm in diameter. The prognosis was not statistically siginficant influenced by histology, gender and surgical methods. The 10-year survival rate for papillary carcinomas was 91% and for follicular carcinomas 84%. Conclusions: We recommend yearly follow-up examinations with selective use of other diagnostic methods in order to provide best patient care.