Patients with distant metastases have a long-term survival that depends, in addition to other factors, on age and the degree of radioiodine uptake in distant metastases.

The purpose was to analyze survival and its predicting factors in differentiated thyroid carcinoma (DTC) patients with distant metastases (M1). Radioiodine ((131)I) therapy was performed in 363 DTC patients from 1977 to 2000. Among 75 patients, 44 patients had M1 at the time of initial therapy and 31 patients had M1, which developed during the follow up. The probability of survival and its predicting factors were tested by Kaplan-Meier's method. Seventy five DTC patients with M1 included 49 (65.3%) women and 26 (34.7%) men; 30 (40%) patients were < 45 years old and 45 (60%) patients were >or= 45 years old (range 8-70 years; mean age = 45.5 years); 52 papillary carcinomas, 22 follicular carcinomas, and one inconclusive finding. Probability of survival after appearance of M1 was 60.7% at 5 years, 51.2% at 10, and 38.4% at 15 and 20 years. Some predicting factors showed significant influence on the survival: age (p = 0.0001), histological type (p = 0.0138), and initial therapy (p = 0.0351), while gender had no influence (p = 0.2046). We can conclude that patients' age, histopathology of the tumor, and initial therapy significantly influence the survival. Longer survival of DTC patients with M1 could be achieved by adequate surgery followed by 131I therapy.

Distant metastases occur late more often in patients with follicular carcinoma while M1-initial is detected more often in patients with papillary carcinoma. DSS was not significantly different among patients with M1-initial and M1-late. The risk of death from M1 increased after the age of 45 years.

Background The principles of global surgery should be taught as a part of the core curriculum in medical schools. The need for medical students to be familiar with the topic is increasing in acceptance. There is, however, a paucity of data on how medical students are exposed to global surgery. This study aims to evaluate exposure of medical students to global surgery, awareness of the key messages of the Lancet Commission on Global Surgery, global surgery career aspirations and barriers to said aspirations. Methods ISOMERS was a multi-centre, online, cross-sectional survey of final year medical students globally. The questionnaire utilised a combination of Likert-scale, multiple-choice, and free text questions. Results In this study, 1593 final year medical students from 144 medical schools in 20 countries participated. The majority (n = 869/1496, 58.1%) believed global surgery to be relevant, despite 17.7% (n = 271/1535) having any exposure to global surgery. Most participants (n = 1187/1476, 80.4%) wanted additional resources on global surgery. Difficulty in providing appropriate care for patients living abroad (n = 854/1242, 68.8%) was the most common perceived barrier to a career in global surgery. Conclusions Participants believed global surgery was a relevant topic for medical students and wanted additional resources that they could access on global surgery. It is critical for medical students to become aware that global surgery is a field that aims to address inequity in surgical care not just internationally, but nationally and locally as well.

Only an early diagnosis of the nodular goiter together with an up-to-date treatment can cure TM patients in a high percentage and prevent development of a terminal stage of the disease which is extremely severe in all forms of this malignancy.