Prognostic indicators of outcomes in patients with lung metastases from differentiated thyroid carcinoma during long-term follow-up
- Authors
- Sohn, Seo Young; Kim, Hye In; Kim, Young Nam; Kim, Tae Hyuk; Kim, Wook; Chung, Jae Hoon
- Issue Date
- Feb-2018
- Publisher
- WILEY
- Keywords
- differentiated thyroid carcinoma; lung metastasis; radioiodine
- Citation
- CLINICAL ENDOCRINOLOGY, v.88, no.2, pp.318 - 326
- Indexed
- SCIE
SCOPUS
- Journal Title
- CLINICAL ENDOCRINOLOGY
- Volume
- 88
- Number
- 2
- Start Page
- 318
- End Page
- 326
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/150523
- DOI
- 10.1111/cen.13489
- ISSN
- 0300-0664
- Abstract
- Background: Distant metastases, although uncommon, represent maximum disease-related mortality in differentiated thyroid carcinoma (DTC). Lungs are the most frequent sites of metastases. We aimed to evaluate long-term outcomes and identify prognostic factors in metastatic DTC limited to the lungs.
Methods: This retrospective study included 89 patients with DTC and metastases limited to the lungs, who were treated between 1996 and 2012 at Samsung Medical Center. Progression-free survival (PFS) and cancer-specific survival (CSS) rates were evaluated according to clinicopathologic factors. Cox regression analysis was used to identify independent factors associated with structural progressive disease (PD) and cancer-specific death.
Results: With a median follow-up of 84 months, the 5- and 10-year CSS rates were 78% and 73%, respectively. Older age at diagnosis (˃= 55 years), radioactive iodine (RAI) nonavidity, preoperative or late diagnosis of metastasis and macro-nodular metastasis (˃= 1 cm) were predictive of decreased PFS and CSS. Multivariate analysis identified older age (P = .002), RAI nonavidity (P = .045) and preoperative (P = .030) or late diagnosis (P = .26) as independent predictors of structural PD. RAI avidity was also independent predictor of cancer-specific death (P = .025).
Conclusion: Patients with DTC and metastatic disease limited to the lungs had favourable long-term outcomes. Age, RAI avidity and timing of metastasis were found to be major factors for predicting prognosis.
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