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Although papillary thyroid cancer is more aggressive in patients 18 and younger, this population is well known to have better prognoses, showing that age is the most important factor in the disease's prognosis.

Although papillary thyroid cancer is more aggressive in patients 18 and younger, this population is well known to have better prognoses, leading a group of Italian researchers to conclude that age is the most important factor in the disease's prognosis.

The researchers, affiliated with the University of Pisa, evaluated the records of 2,709 patients who had undergone total thyroidectomy there from 2000 to 2005 and report their findings in the February issue of Otolaryngology--Head and Neck Surgery.

Patients were divided into three groups based on age at presentation: 18 and younger (Group 1), 19 - 45 (Group 2), and 46 and older (Group 3).

Tumor size was significantly larger in Group 1 (p < 0.0001 versus both other groups). Group 2 in turn showed significantly larger tumors than Group 3. Patients in Group 3 were the most likely to have microcarcinomas, tumors smaller than 1 cm.

In addition, infiltration of the thyroid capsule and the incidence of node metastases were significantly more common in Group 1 than in the other two groups. In terms of histological subtypes, classic and follicular variants were equally represented in all three groups, although the Tall-cell variant, which implies a poorer prognosis, was not found in Group 1.

"In the pediatric population," Dr. Michele Minuto told Reuters Health, "papillary thyroid cancer presents at a worse stage (greater tumor size and more frequent node metastases). Since we know from the literature that the pediatric population has a far better prognosis, those two prognostic features do not play any role in the survival of patients, and younger age can be considered as the main favorable factor."

However, this remains to be verified in the current population. As the researchers point out in their paper, the follow-up of the study cohort is still too short to allow them to report on survival rates, "due to the excellent prognosis and long-term survival of patients with papillary thyroid cancer.