Differentiated Thyroid Carcinoma Presenting With Distant Metastasis at Initial Diagnosis

Lee, Jandee; Soh, Euy Young

doi:10.1097/sla.0b013e3181b7faf6

Cited by 126 publications

(150 citation statements)

References 16 publications

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“…Most patients develop distant metastases in the lungs; over 50% (ref. 36 ) have this involvement alone, 25% (ref. 36 ) have bone involvement alone, 20% (ref.…”

Section: Extrathyroidal Extensionmentioning

confidence: 99%

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The epidemiology of thyroid cancer in the Czech Republic in comparison with other countries

Lukas¹,

Drábek²,

Lukáš³

et al. 2013

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background. Thyroid cancer includes a broad spectrum of tumours with different prognoses. The global incidence has been increasing in recent years. Variables affecting its etiology are dietary, especially iodine intake and to a lesser extent selenium, environmental, like -ionizing radiation and, increased TSH level. These factors interplay with epigenetic and genetic changes within the cell. This review article presents thyroid cancer epidemiology, describes its main characteristics and the influence of environmental and lifestyle risk factors in the Czech Republic in comparison with other countries. Methods and Results. An epidemiological study of Czech patients with malignant thyroid carcinoma was made on the basis of the National Oncologic Registry (NOR) and Czech Statistical Office data summarized on the web portal SVOD. The data were compared with international data from the project GLOBOCAN 2008 Cancer Incidence and Mortality Worldwide. Apart from risk factors, prognostic factors with effect on patient survival were also analyzed. The survey showed that the incidence of thyroid cancer has been steadily growing in the Czech Republic. Since the beginning of the 1980s, it has increased 4 fold. It has a higher incidence than most other European countries but it is ranked with countries with an average and decreasing mortality. Obviously, the improved detection methods do not explain the growing incidence. The highest incidence is found for papillary carcinoma (PTC), now over 80% of cases. For follicular and medullar cancers, the incidence has not increased and for anaplastic carcinoma there is a slight decrease. Women over 40 years of age constitute the highest risk group. Conclusions. There are a number of reasons for these trends, such as improved diagnostic techniques using ultrasound and FNAB and more radical surgery. There are also dietary/environmental factors (iodine deficiency and to a lesser extent selenium), nitrates, polychlorinated biphenyls, increased ionizing radiation, and prolonged increase in TSH. The prognosis of patients with DTC depends on the age at the time of diagnosis. A favorable prognosis also depends on timely detection.

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“…Most patients develop distant metastases in the lungs; over 50% (ref. 36 ) have this involvement alone, 25% (ref. 36 ) have bone involvement alone, 20% (ref.…”

Section: Extrathyroidal Extensionmentioning

confidence: 99%

“…36 ) have this involvement alone, 25% (ref. 36 ) have bone involvement alone, 20% (ref. 36 ) have both lung and bone involvement and about 5% (ref.…”

Section: Extrathyroidal Extensionmentioning

confidence: 99%

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The epidemiology of thyroid cancer in the Czech Republic in comparison with other countries

Lukas¹,

Drábek²,

Lukáš³

et al. 2013

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…Most previous studies categorize metastatic lesions as synchronous or metachronous (5,9,11,12). Synchronous metastasis is defined as the presence of a distance metastasis at the time of, or within a few months of, the initial diagnosis and includes patients whose metastatic lesions were found on the initial post-therapeutic wholebody scan (WBS) (RxWBS) after radioactive iodine (RAI) therapy (RAIT).…”

Section: Introductionmentioning

confidence: 99%

Early prognostic factors at the time of diagnosis of bone metastasis in patients with bone metastases of differentiated thyroid carcinoma

Choi

Kim²,

Kwon³

et al. 2016

European Journal of Endocrinology

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Objective: Bone is the second most common site of distant metastases from differentiated thyroid cancer (DTC). Patients with bone metastases were associated with poor clinical outcomes; however, their clinical courses are heterogeneous. The aim of this study is to evaluate early prognostic factors of patients with bone metastases from DTC at the time of diagnosis of bone metastasis. Methods: This retrospective study included 93 patients with bone metastases from DTC. We defined 'Pre-RAIT group' as patients whose bone metastases were detected before initial RAIT. The 'post-RAIT group' was defined as patients whose bone metastases were detected after initial RAIT or during the follow-up period. Results: Median age was 55.4 years, and 55 patients (59%) had papillary thyroid cancer. Patients in the pre-RAIT group (n = 32) demonstrated significantly poorer overall survival (OS) (HR = 1.86, P = 0.04) than those in the post-RAIT group. There was no significant difference in the OS according to the initial RAI avidity among all patients (P = 0.18). RAI-avid bone metastases had better OS only in the pre-RAIT group (HR = 0.23, P = 0.01) but not in the post-RAIT group. In the post-RAIT group, older age (>45 years), elevated serum thyroglobulin (Tg) level (>250 ng/mL), and the presence of skeletal-related events (SREs) were significantly associated with poor OS. RAI avidity was not a significant prognostic factor in the post-RAIT group (P = 0.33). Conclusions: Patients whose bone metastases were diagnosed before initial RAIT demonstrate a poorer prognosis. RAI avidity is an early prognostic indicator in the pre-RAIT group. Old age, higher serum Tg levels, and SRE are associated with poor survival outcomes in the post-RAIT group.

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“…Distant metastasis occurs in 4-23% of DTC patients and the lung is the most frequent site of distant metastasis (1-7). The 10-year survival rate after a diagnosis of metastatic DTC ranges from 25% to 70%, and patients with metastatic DTC have markedly varying clinical outcomes from rapid progression and death to complete remission, suggesting a heterogeneity in those patients (2,6,(8)(9)(10)(11)(12)(13)(14). Several retrospective studies have shown that the prognostic factors for the survival of metastatic DTC include age at diagnosis (9,14,15), histology of the tumor (14,16), site of metastasis (14,15), and 131 I avidity (9,15,16).…”

mentioning

confidence: 99%

Long-Term Prognosis of Differentiated Thyroid Cancer with Lung Metastasis in Korea and Its Prognostic Factors

Cho

Choi²,

Yeom³

et al. 2014

Thyroid

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Background: Distant metastasis, generally to lung and bone, is rare in differentiated thyroid carcinoma (DTC) and the prognosis is still elusive. We investigated long-term outcomes of lung metastasis in DTC patients and its prognostic factors. Methods: A retrospective review was performed of 4572 patients who underwent surgery for DTC from 1962 to 2009 at Seoul National University Hospital. Among them, 164 patients were identified with lung metastasis and 152 patients were enrolled in the final analysis. Poor prognosis was defined as progressive disease or death. Results: Of these 152 patients, 10-and 20-year survival rates were 85.0% and 71.0%, respectively. No evidence of disease, stable disease, progressive disease, and death was identified in 22.4%, 28.3%, 35.5%, and 13.8%, respectively, after 11 years of median follow-up (range 2-41 years). Older age at diagnosis ( ‡ 45 years), primary tumor size ‡ 2 cm, follicular thyroid cancer, metastasis diagnosed after initial evaluation or 131 I remnant ablation (late metastasis), multiple metastases other than lung, 131 I nonavidity, and the presence of macronodules ( ‡ 1 cm) were more frequent in poor prognoses. Cox proportional hazard ratio for progression-free survival showed that 131 I nonavidity was the only independent predictive factor for poor prognosis. Conclusions: The prognosis of lung metastasis from DTC in Korea within this study was favorable.

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Differentiated Thyroid Carcinoma Presenting With Distant Metastasis at Initial Diagnosis

Cited by 126 publications

References 16 publications

The epidemiology of thyroid cancer in the Czech Republic in comparison with other countries

The epidemiology of thyroid cancer in the Czech Republic in comparison with other countries

Early prognostic factors at the time of diagnosis of bone metastasis in patients with bone metastases of differentiated thyroid carcinoma

Long-Term Prognosis of Differentiated Thyroid Cancer with Lung Metastasis in Korea and Its Prognostic Factors

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