Prognosis
Overall, thyroid cancer has an excellent prognosis.[18]
The most common type, papillary carcinoma, is indolent, with an average 10-year survival >90%.[1] Recurrence and risk of metastasis are low after surgery. Surgical complications are few when surgery is done by experts. Nodal metastases in papillary carcinoma increase the risk of recurrence but do not affect overall survival. If a patient has undergone positron emission tomography (PET) scanning, a positive scan is an indicator of worse prognosis than a negative result. Most patients who undergo PET scanning are older patients who have poorly differentiated tumours.
Follicular carcinoma has a slightly worse prognosis than papillary and tends to have systemic metastasis. The survival rate for localised follicular cancer is almost 100% and for distant follicular cancer is 63%.[88]
Oncocytic carcinoma (previously known as Hürthle cell carcinoma) prognosis differs between minimally and widely invasive oncocytic carcinoma, with no recurrence observed in those with minimally invasive oncocytic carcinoma.[2] The overall 5-year survival rate of oncocytic carcinoma is 85% to 95%.[2]
Overall 5-year survival for localised medullary carcinoma is almost 100% and for distant medullary carcinoma is 75%.[88]
For primary thyroid lymphoma, the 5-year survival is 66%.[5]
Anaplastic carcinoma is aggressive, with a historical average survival of a few months. Molecular testing at patient presentation became standard of care in the 2014-2019 era, and the use of targeted therapy is associated with improved median overall survival of 1.31 years in those receiving targeted therapy versus 0.63 years in those who did not.[89]
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