Long-term outcome of 65 patients with metastatic differentiated thyroid carcinoma
Marta Dieguez, Edelmiro Menendez, Cecilia Sanchez, Javier Aller, Pedro Boix, Elias Delgado, Antonio Lavilla, Joaquin Pertierra & Antonio Rabal
Aim: To assess survival rate and prognosis factors in a group of 65 patients with distant metastases from differentiated thyroid carcinoma.
Methods: Patients with metastatic differentiated thyroid carcinoma (MDTC) were retrospectively identified from the database of a single institution (19752008). Disease-specific survival (DSS) was analyzed by the Kaplan-Meier method.
Results: A total of 65 patients with MDTC were identified. The median follow-up was 90 months (range 3328). Metastatic lesions were treated with radioactive iodine (77%), radiotherapy (18%), surgical resection (17%) and chemotherapy (3%). Following RECIS criteria, after treatment 70% of metastases progressed, 14% remained stable, 8% had a partial response and 9% had a complete response.
The overall survival rate was 59.5 months (CI 67122). Disease-specific survival (DSS) was 39% at 5 years and 26% at 10 years.
Patients with micronodular pulmonary metastases and isolated bone metastases had significant longer DSS than patients with other type of metastases: 71% versus 25% at 5 years and 50% versus 16% at 10 years, respectively (P < 0.05).
Aged <45 years and iodine-avid metastases were also associated with better outcome.
No difference was observed for sex, TNM stage and time of diagnosis of metastases.
Conclusions: The current study, as well as others, suggests that MDTC may have a long-term survival.
Despite of treatment most metastases progress.
Age, site and extension of metastases and radioiodine uptake are the strongest prognosis factors.