The Benefit of Primary Tumor Surgical Resection in Distant Metastatic Carcinomas of the Thyroid

Abstract

Objectives/Hypothesis Thyroid cancer with distant metastasis (TCDM) at diagnosis has significantly worse survival rates when compared to localized/regional thyroid cancer. This study sought to report on the characteristics of patients presenting with TCDM and the potential survival advantage of surgical resection. Study Design Data were acquired from the Surveillance, Epidemiology, and End Results (SEER) database with cases from 2004 to 2015. Methods TCDM cases (n = 2,558) were identified from the SEER database. The Bonferroni correction was applied for multivariate analysis. Kaplan‐Meier analysis was utilized to obtain disease‐specific survival (DSS) rates. Cox regression analysis was utilized to identify independent factors significantly associated with survival. Results The average age of diagnosis of TCDM was 62.0 (±17.5) years. Patients were predominantly white (74.6%), female (54.6%), in a relationship (56.0%), and between ages 36 and 80 years (76.4%). Cases consisted of papillary (57.2%), follicular (16.0%), medullary (8.9%), anaplastic (17.9%) TCDM histological variants. Overall 1‐, 5‐, and 10‐year DSS rates were 72.0%, 56.8%, and 43.8%, respectively. Anaplastic and medullary variants had the worst 10‐year DSS (0% and 25.5%, respectively). Patients who underwent surgical resection only and surgical resection with radiation were 49% and 59% less likely to die, respectively. Treatment, age, histology, T staging, relationship status, and metastasis site were determined to be significant predictors of survival. Conclusions Surgical resection with radiation was found to be a significant predictor of survival after applying the Bonferroni correction for all thyroid cancer variants except medullary. To increase survival, surgical intervention should be recommended in patients who are deemed to be medically tolerant of surgery. Level of Evidence 4 Laryngoscope, 131:1026–1034, 2021

Risk of second primary malignancy after radioiodine for thyroid carcinoma: a SEER-based study

“…We excluded SPM diagnosed within 12 months of the thyroid cancer diagnosis, which may be another important cause. In addition,, patients with stage regional and distant had greater CSM than localized in the no-RAI group, RAI was associated with improved CSM particularly in distant metastatic thyroid cancer, it was consistent with previous studies (30,31). We found that the mortality rate after RAI treatment is higher than that of no-RAI in all subgroups except for regional and distant metastasis.…”

Hazard ratios of second primary malignancy after radioiodine for differentiated thyroid carcinoma: a large-cohort retrospective study

“…In addition, patients in the RAI group with regional or distant stage had lower CSM compared to those in the non-RAI group, especially in patients with distant metastatic thyroid cancer. These results indicate that RAI treatment may improve thyroid CSM, it was consistent with previous studies [31,32]. We found that the mortality rate after RAI treatment was higher than that of non-RAI in all subgroups except for regional and distant metastasis.…”