PurposeTo describe the overall survival and progression-free survival in patients diagnosed with differentiated thyroid carcinoma with synchronous and metachronous metastatic involvement.Materials and methodsA retrospective cohort study was conducted with 101 patients with differentiated thyroid cancer (DTC) who had metastatic involvement at diagnosis or during follow-up, who were treated at the National Cancer Institute between January 1, 2010 and December 31 of 2015.Results81 patients (80.2%) were women and the mean age at diagnosis was 49 years (12–80). Synchronous metastases were detected in 54.5% of patients and metachronous metastasis was diagnosed in 45.5% of patients, in whom the mean time between initial diagnosis and the finding of distant metastases was 5 years. Pulmonary involvement occurred in almost all patients, with131I uptake in 58% of synchronous metastases and in 21% of metachronous. There were 10 events in the patients with131I-avid metastases with a median time to progression that was not reached, and there were 23 events in patients with131I-refractory metastases with a median time to progression of 96 months; The median time to progression was significantly longer in patients with synchronous metastases compared to those with metachronous metastases (Not reached vs 95 months,P= 0.017) The 5-year overall survival rate was 95% to the entire cohort.ConclusionsThe present study contributes to the expansion of the knowledge about this clinical course of DTC with the finding of a worst prognosis in patients with metachronous metastases.