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Well-differentiated tumors are the most common form of thyroid cancer. Their prognosis is generally favourable, with 12 year survival rates in excess of 90%. Local relapse of the disease is observed in 20%-30% of cases, with latero-cervical metastases or distant metastases. Several risk factors have been identified that influence the prognosis, such as age, presence of distant metastases at the time of diagnosis, extrathyroid extension (ETE), diameter and tumor grade (1-5).
The locally advanced well-differentiated tumor of the thyroid is a tumor with interruption and invasion of the capsula sometimes involving the surrounding cellulomuscular tissue and possibly the surrounding structures, such as the trachea, esophagus, veins; it accounts for between 4% and 16% of cases and is accompanied by an increase in percentage relapse and mortality rate (6-8); in particular, invasion of the thyroid capsule is considered a very important risk factor in the onset of distant metastases (5).