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BACKGROUND: A delay in the diagnosis of differentiated thyroid carcinoma often leads to larger tumors, higher prevalence rates of distant metastasis, and earlier cause-specific deaths. Threshold tumor diameters for extrathyroidal growth, lymph node spread, and distant metastasis in papillary (PTC) and follicular thyroid carcinoma (FTC) remain to be defined. METHODS: A comparative correlation of primary tumor size and extrathyroidal growth, lymph node spread, and distant metastasis was performed for 500 institutional patients who received surgery for PTC or FTC. RESULTS: There were 366 patients with PTC (73.2%) and 134 patients with FTC (26.8%). Multifocality (23.5% vs. 9.0%; P 20 mm. Pulmonary metastasis was an earlier event than bone metastasis. CONCLUSIONS: The data suggested that earlier intervention is warranted to keep suspicious thyroid nodules from growing > 20 mm (or greater than T1) and spreading to distant organs.
Machens et al. (Tue,) studied this question.