INTRODUCTION: Differentiated thyroid cancer (DTC), including papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC), isthe most common endocrine malignancy and is usually associated with a favorable prognosis. However, clinicopathological characteristicsand prognostic factors may differ between these histological subtypes. MATERIAL AND METHODS: We performed a retrospective analysis of 1,826 consecutive patients (1,533 with PTC and 293 with FTC) whounderwent surgical treatment between 1995 and 2025 at a tertiary referral center. Clinicopathological features, recurrence patterns,and disease-specific survival (DSS) were assessed. Tumors were staged according to the AJCC/UICC TNM classification (8th edition).Survival probabilities were estimated using the Kaplan-Meier method and compared with the log-rank test. Independent prognosticfactors were evaluated using multivariable Cox proportional hazards regression analysis. RESULTS: Follicular thyroid carcinoma was significantly associated with larger tumor size, extrathyroidal extension, and distant metastases at diagnosis, whereas lymph node metastases and multifocality were more frequently observed in PTC. Ten-year DSS was significantly higherin patients with PTC than in those with FTC (98.4% vs. 89.6%; p < 0.001). In multivariable analysis, older age, larger tumor size, and distantmetastases were independent predictors of worse DSS in PTC. In FTC, extrathyroidal extension, locoregional recurrence, and distant metastaseswere independently associated with reduced DSS. CONCLUSIONS: Although long-term survival in DTC is excellent, significant differences in biological behavior and prognostic determinantsexist between PTC and FTC. Histology-specific risk assessment may improve long-term management and follow-up strategies.
Kowalski et al. (Tue,) studied this question.
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