Kim, Hyeung Kyoo1,2; Lee, Inhwa1; Lee, Jeonghun1; Chang, Hang-Seok2; Park, Cheong Soo1; Soh, Euy Young1
1 Department of Surgery, Ajou University School of Medicine, Suwon, South Korea
2 Department of Surgery, Gangnam severance hospital, Yonsei University College of Medicine, Seoul, South Korea
Background / Aims: Differentiated thyroid cancer has a good prognosis. But, differentiated thyroid carcinoma presenting with distant metastasis have a particularly poor prognosis. We aimed to evaluate the cancer-specific survival in DTC patients presenting with distant metastasis
Methods: A retrospective medical record review was undertaken of patients with stage M1 differentiated thyroid cancer at presentation (n=93), referred from 1982–2013 at a single institution.
We compared cancer specific survival for two groups: (1) 70 patients was metachronous distant metastasis. (2) 23 was synchronous distant metastasis.
Results: The median age was 50 (range, 11-87), with 63% females. Histology: papillary, 76(81.7%), follicular 17(18.3%). The initial site(s) of metastasis were lung only, 64.5%, bone only, 9.7%, lung and bone 19.4%, other multiple site 6.5%. All patients underwent a thyroidectomy. Additional treatment(s) included: Radioactive iodine(RAI), 95.37%, excision of metastasis, 16.1%, radiotherapy(EBRT), 15.1%, and chemotherapy or anti-cancer drug, 14%. With a median follow-up time of 114 months, 82 patients are alive (88.2%) and 11 died (11.8%), synchronous distant metastasis has 5-year survivals of 91.3%, 10-year survivals of 78.3% and metachronous distant metastasis has 5-year survivals of 88.3%, 10-year survivals of 66.2%.(P=0.995)
Conclusions: Differentiated thyroid cancer patients with distant metastasis can have long periods of cancer-specific survival.(10-year survival of 71.7%). There were no significant difference between synchronous and metachronous metastasis. DTC Patient with synchronous distant metastasis need to do more on active treatment.
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- J Am coll Surg. (2003) 19: 191-197 Prognostic Indicators of Outcomes in Patients with Distant Metastases from Differentiated Thyroid Carcinoma