Radioactive Iodine Therapy in Patients With Thyroid Carcinoma With Distant Metastases: A SEER-Based Study

Li, Chenyuan; Wu, Qi

doi:10.1177/1073274820914661

Cited by 20 publications

(23 citation statements)

References 29 publications

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“…Similar to previous reports, lung was found to be the most common site of distant metastases 12,23,24,38,63 . While not significant, patients with bone metastases showed a trend for better survival in this study.…”

Section: Discussionsupporting

confidence: 90%

“…The control group was matched to the DM group based on the following criteria: age at presentation, gender, tumour size and histology. The criteria for this matching process were based on the fact that age, 5,7,23,25–36 gender, 5,7,13,23,27,28,31–34 tumour size 5,7,13,21,25–28,30,32,34,37 and histology 5,7,13,21,23,27,28,32–34,36–38 have consistently been shown to be significant prognostic markers for DTC. Three patients in the control group were found to later develop DM during follow‐up and hence were excluded from the study.…”

Section: Methodsmentioning

confidence: 99%

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Predicting distant metastatic disease in differentiated thyroid cancer: a matchedcase–controlstudy

Jaffar

Jayasekara

Aniss

et al. 2021

ANZ Journal of Surgery

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Background The occurrence of distant metastasis (DM) is the most important prognostic factor influencing survival outcomes in differentiated thyroid cancer (DTC). Identifying patients who are likely to develop DM and offering these cases more aggressive surgical approaches and I‐131 therapy, is paramount to achieving the best possible outcomes. DM on presentation in DTC are uncommon, with an incidence of 1–9%. However, the incidence of DTC is rising and the disease affects a relatively young cohort of patients. The aims of this study were to investigate predictive factors in the development of DM by comparing a homogenous group of DTC patients with and without DM, and to illustrate the overall and disease‐specific survival (DSS) rates of DTC patients presenting with DM. Methods A matched case–control study of patients with DTC and DM was undertaken. The study group comprised a consecutive series of cases with DM treated in the period 1968–2014. Patients with DM at initial presentation were identified (DTC‐DM group). A control group of patients without DM were matched based on age, gender, tumour size and histological subtype. The primary outcome measures were overall and disease‐free survival. Secondary outcome measures were lymph node involvement (LNI), extra‐thyroidal extension (ETE) of tumour and presence of BRAFV600E mutation identified on immunohistochemistry. Results A total of 2547 patients with DTC were reviewed and of these 83 (3.26%) had DM at initial presentation. At 5 and 10 years, the overall survival rates for DTC‐DM patients were 89.6% and 64%, respectively. The 5 and 10 year DSS rates for DTC‐DM cases were 90.2% and 67.3%, respectively. When compared to the DTC group, the DTC‐DM group had significantly higher rates of ETE (63% vs. 29.5%, P < 0.0001) and LNI (32.5% vs. 18.8%, P = 0.044). Among patients with papillary thyroid cancer (PTC), the presence of BRAFV600E mutation was significantly associated with DM (62.2% vs. 36.8%, P = 0.028). Conclusion ETE, LNI and BRAFV600E mutation in PTC are significant predictors for the development of distant metastatic disease.

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Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Predicting distant metastatic disease in differentiated thyroid cancer: a matchedcase–controlstudy

Jaffar

Jayasekara

Aniss

et al. 2021

ANZ Journal of Surgery

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“…The reason why TC patients with distant metastases at diagnosis had a strongly age-dependent survival rate may be explained as follows: rstly, TC patients with advanced age were more likely resistant to radioactive iodine (RAI) treatment (14,23); Secondly, the thyroid-stimulating hormone (TSH) levels would increase with normal aging, which was an independent risk factor for malignancy in thyroid nodules (24); In female patients with menopause, elevated luteinizing hormone (LH)/follicle-stimulating hormone (FSH) could also affect the growth of TC because LH and FSH had the sameαsubunit as TSH (25); Moreover, due to aging, decline in immune system functions and increase in all-cause mortality may also contributed to poor prognosis of TC(26).…”

Section: Discussionmentioning

confidence: 99%

Age increased the cancer‐specific mortality risk of thyroid cancer with lung metastasis

Huang

Xia

Huang

et al. 2022

Clinical Endocrinology

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Background: To investigate the relationship between age and cancer-speci c mortality in thyroid cancer (TC) with lungmetastasis.Methods: 1,418 patients with initial distant metastases from Surveillance, Epidemiology and End Results databases were investigated. Patients with median follow-up time of 8 months [interquartile range (IQR), 2-27] and median age of 66 years (IQR, were divided into ve groups by age and the association between age and TC-speci c mortality was analyzed.Results: The TC-speci c mortality rates were 32.78% (118/360), 46.71% (156/334), 53.93% (199/369), 58.96% (158/268) and 82.76% (72/87) for patients with age of ≤55 years,56-65 years, 66-75 years, 76-85 years and >85 years. Kaplan-Meier curves showed that TC-speci c mortality rate was associated with increased age (p < 0.001). Compared with patients ≤55 years, patients of 56-65 years, 66-75 years, 76-85 years and >85 years had signi cantly higher hazard ratios (HRs) of 1.69(1.26-2.26), 1.97 (1.47-2.64), 2.18(1.59-2.99) and 3.24(2.08-5.06) after adjustments for gender, tumor size and radiation therapy (all p < 0.001).In TC with initial lung-metastasis, compared with patients ≤55 years, patients of 56-65 years, 66-75 years, 76-85 years and >85 years had signi cantly higher adjusted HRs of 1.68(1.20-2.36, p=0.003), 2.18(1.57-3.02), 2.16(1.51-3.08) and 2.91(1.79-4.75) (p < 0.001). Similar results could be obtained in papillary thyroid cancer.Conclusions: The TC-speci c mortality increased with age in TC patients with initial lung-metastasis, which suggested that further risk strati cation based on age was necessary for TC over 55 years with lung-metastasis. Individual treatment strategy maybe recommended for patients over 85 years. BackgroundThyroid cancer (TC) is one of the most common endocrine tumors, and its incidence has been increasing in the past four decades(1). At present, its incidence is rising the second fasted among solid tumors and it has become the sixth most common malignancy in female population in the United States(2, 3). TC is divided into two categories according to the cell origin, one arising from endoderm-derived follicular cells, and the other arising from the neural crest-derived C-cells(4). The former category includes differentiated thyroid cancer (DTC) [papillary thyroid cancer (PTC), follicular thyroid cancer (FTC), and poorly differentiated TC], and anaplastic thyroid cancer (ATC), while the latter category is known as medullary thyroid cancer (MTC)(4). DTC accounts for approximately 90% of all thyroid cancer types.(4, 5) Clinical character of DTC is usually indolent, while ATC is the most aggressive variant, accounting for about 40% of all deaths from TC(5, 6). The most common metastatic site of TC is lung(7), followed by bone, and occasionally brain and liver(8, 9). DTC is a unique malignancy in which age at diagnosis can be an independent risk factor for prognosis (10,11). In 2016, the American Joint Committee on Cancer (AJCC) released eighth edition of the AJCC/TNM cancer staging manual, and changed the age cutof...

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“…The reason why TC patients with distant metastases at diagnosis had a strongly age-dependent survival rate may be explained as follows: rstly, TC patients with advanced age were more likely resistant to radioactive iodine (RAI) treatment (14,23); Secondly, the thyroid-stimulating hormone (TSH) levels would increase with normal aging, which was an independent risk factor for malignancy in thyroid nodules (24); In female patients with menopause, elevated luteinizing hormone (LH)/follicle-stimulating hormone (FSH) could also affect the growth of TC because LH and FSH had the sameαsubunit as TSH( 25); Moreover, due to aging, decline in immune system functions and increase in all-cause mortality may also contributed to poor prognosis of TC(26).…”

Section: Discussionmentioning

confidence: 99%

Age Increased Cancer-specific Mortality Risk of Thyroid Cancer With Lung Metastasis

Huang

Xia

Shen

et al. 2021

Preprint

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Background: To investigate the relationship between age and cancer-specific mortality in thyroid cancer (TC) with lung-metastasis.Methods: 1,418 patients with initial distant metastases from Surveillance, Epidemiology and End Results databases were investigated. Patients with median follow-up time of 8 months [interquartile range (IQR), 2–27] and median age of 66 years (IQR, 55-76) were divided into five groups by age and the association between age and TC-specific mortality was analyzed.Results: The TC-specific mortality rates were 32.78% (118/360), 46.71% (156/334), 53.93% (199/369), 58.96% (158/268) and 82.76% (72/87) for patients with age of ≤55 years,56-65 years, 66-75 years, 76-85 years and >85 years. Kaplan-Meier curves showed that TC-specific mortality rate was associated with increased age (p < 0.001). Compared with patients ≤55 years, patients of 56-65 years, 66-75 years, 76-85 years and >85 years had significantly higher hazard ratios (HRs) of 1.69(1.26-2.26), 1.97 (1.47-2.64), 2.18(1.59-2.99) and 3.24(2.08-5.06) after adjustments for gender, tumor size and radiation therapy (all p < 0.001).In TC with initial lung-metastasis, compared with patients ≤55 years, patients of 56-65 years, 66-75 years, 76-85 years and >85 years had significantly higher adjusted HRs of 1.68(1.20-2.36, p=0.003), 2.18(1.57-3.02), 2.16(1.51-3.08) and 2.91(1.79-4.75) (p < 0.001). Similar results could be obtained in papillary thyroid cancer.Conclusions: The TC-specific mortality increased with age in TC patients with initial lung-metastasis, which suggested that further risk stratification based on age was necessary for TC over 55 years with lung-metastasis. Individual treatment strategy maybe recommended for patients over 85 years.

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Radioactive Iodine Therapy in Patients With Thyroid Carcinoma With Distant Metastases: A SEER-Based Study

Cited by 20 publications

References 29 publications

Predicting distant metastatic disease in differentiated thyroid cancer: a matchedcase–controlstudy

Predicting distant metastatic disease in differentiated thyroid cancer: a matchedcase–controlstudy

Age increased the cancer‐specific mortality risk of thyroid cancer with lung metastasis

Age Increased Cancer-specific Mortality Risk of Thyroid Cancer With Lung Metastasis

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