Prognostic factors in well-differentiated thyroid cancer.

Abstract

The differentiated thyroid carcinomas are malignant neoplasms most of them following an indolent course with infrequent metastases and long survival. However, a few cases behave in an aggressive fashion and, despite every attempt to treat, cause the death of the patient. Numerous investigations have been carried out to define the markers which affect the prognostic course of these tumors. There are three types of prognostic markers: clinicopathological, pathological (morphological) and biological. The first group include: age, sex, size of the tumor, multifocality, vascular and extrathyroidal invasion, grading and metastases. The second category collects some morphological features like tumor subtype, association with autoimmune thyroid diseases and ploidy. The last group features the oncogenes (RET and RET/PTC rearrangements). The accurate evaluation of all the previous prognostic markers is the basis of the treatment schemes discussed in the last section.