Papillary 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
If left untreated, patients with papillary thyroid cancer may progress to develop metastasis. Common complications of papillary thyroid cancer include vocal cord compression, dysphagia, and dyspnea. The presence of metastasis is associated with a particularly poor prognosis among patients with papillary thyroid cancer. The 5 year event free survival rate is 51% for stage 4 disease.
Natural History
The symptoms of papillary thyroid cancer usually develop in the third or fourth decade of life, and start with symptoms such as painless lump in the neck. Without treatment, the patient will develop symptoms of compression and metastasis, which may eventually lead to death.
Complications
- Metastasis
- Vocal cord compression
- Dysphagia
- Dyspnea
Prognosis
- Prognosis of patients with papillary thyroid cancer is found to be dependent on the patient's age, size of the tumor, presence of metastatic disease, and presence of tumor invasion into adjacent tissues near the thyroid gland.
Depending on source, the overall 5-year survival rate for papillary thyroid cancer is 96 percent[1] or 97 percent,[2] with a 10-year survival rate of 93 percent.[1]
For a more specific prognosis for individual cases, there are at minimum 13 known scoring systems for prognosis; among the more often used are:
- AGES - Age, Grade, Extent of disease, Size
- AMES - Age, Metastasis, Extent of disease, Size
- MACIS - Metastasis, Age at presentation, Completeness of surgical resection, Invasion (extrathyroidal), Size[3] (this is a modification of the AGES system). It is probably the most reliable staging method available. Also known as the MAICS system.
- TNM staging - Tumor, node, metastasis. Remarkable about the TNM staging for (differentiated) thyroid carcinoma is that the scoring is different according to age.
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.[4]
- Stage 1 has 100% 5 year relative survival rate
- Stage 2 has 100% 5 year relative survival rate
- Stage 3 has 93% 5 year relative survival rate
- Stage 4 has 51% 5 year relative survival rate
References
- ↑ 1.0 1.1 Numbers from National Cancer Database in the US, from Page 10 in: Biersack, H-J; Grünwald, F (Eds) (2005). Thyroid Cancer. Berlin: Springer. ISBN 3-540-22309-6. (Note: Book also states that the 14 percent 10-year survival for anaplastic thyroid cancer was overestimated)
- ↑ Rounded up to nearest natural number from 96.7 percent as given by eMedicine > Thyroid, Papillary Carcinoma Author: Luigi Santacroce. Coauthors: Silvia Gagliardi and Andrew Scott Kennedy. Updated: Sep 28, 2010
- ↑ "New York Thyroid Center: Prognosis Staging for Thyroid Cancer". Retrieved 2007-12-22.
- ↑ Thyroid Cancer Cancer.org (2015).http://www.cancer.org/acs/groups/cid/documents/webcontent/acspc-030369-pdf.pdf- Accessed on November,4 2015