Thick tumor capsule is a valuable risk factor for distant metastasis in follicular thyroid carcinoma.

Abstract Objective While the biological behavior of follicular thyroid carcinoma (FTC) has been studied in great detail using clinical experience, few studies have investigated pre- or intraoperative factors related to the risk of distant metastasis (DM) among patients with FTC. The aim of this study was to analyze the characteristics of FTC with DM. Methods This study retrospectively investigated 102 patients with FTC who underwent surgery between 1988 and 2013. We compared clinicopathological characteristics between FTC with and without DM. Results Univariate analysis revealed nodal metastasis (p = 0.045), serum thyroglobulin (Tg) at initial operation (≥1000 ng/ml; p  Conclusion Patients with these risk factors should undergo total thyroidectomy and radioactive iodine ablation.