Follicular Carcinoma of the Thyroid Gland: Prognostic Factors, Treatment, and Survival.Zidan, Jamal M.D.; Kassem, Samer M.D.; Kuten, Abraham M.D.American Journal of Clinical Oncology: February 2000 - Volume 23 - Issue 1 - pp 1-5 Original Article Abstract Author Information Prognostic variables and treatment outcomes of 82 patients treated at the Northern Israel Oncology Center were reviewed. There were 59 women and 23 men in this series. The female/male ratio was 2.6/1. Median age was 46 years. Median follow-up was 11.4 (range: 3.8-24 years). Median tumor size was 3.6 cm. When first seen, 4 patients had lymph node involvement and 11 (13%) had distant metastases. Surgical treatment was total thyroidectomy in 37 patients (45%), subtotal thyroidectomy in 38 (46%), and lesser procedures in 7 (9%). Sixty-six patients (80%) were treated after surgery with 131I to ablate thyroid remnants. Doses ranged between 30 and 80 mCi. The 20-year overall actuarial survival rate was 65%. The actuarial survival rate of patients <40 years of age was 96% versus 33% in patients >50 years of age (p = 0.0008). Patients with distant metastases at presentation had inferior survival compared with patients without metastases. In conclusion, we found subtotal thyroidectomy followed by 131I and hormone therapy to provide survival similar to that with total thyroidectomy, with less morbidity. Risk factors include: age ≥40 at the time of diagnosis, presence of distant metastases, capsular invasion, tumor size ≥2 cm, and male gender. From the Oncology Unit, Rebecca Sieff Government Hospital (J.Z.), Safed; and Northern Israel Oncology Center, Rambam Medical Center (S.K., A.K.) and Faculty of Medicine, Technion-Israel Institute of Technology (J.Z.), Haifa, Israel. Address correspondence and reprint requests to Dr. Jamal Zidan, Oncology Unit, Rebecca Sieff Government Hospital, P.O. Box 1008, Safed 13100, Israel. © 2000 Lippincott Williams & Wilkins, Inc.