Prognostic Implications of Radioiodine Avidity and Serum Thyroglobulin in Differentiated Thyroid Carcinoma with Distant Metastasis
- 2 October 2013
- journal article
- research article
- Published by Wiley in World Journal of Surgery
- Vol. 37 (12), 2845-2852
- https://doi.org/10.1007/s00268-013-2213-4
Abstract
Although differentiated thyroid carcinoma (DTC) rarely develops distant metastases, the present study was performed to evaluate factors that affect the survival of patients with DTC who present with distant metastasis. Among 4,989 patients who underwent thyroid surgery for DTC, 82 presenting with distant metastasis were analyzed. Based on radioiodine (131I) avidity and the thyroid-stimulating hormone-stimulated serum thyroglobulin (sTg) level at the time of metastasis, patients were divided into three groups: group 1 (131I uptake + sTg ≤ 215 ng/mL, n = 46), group 2 (131I uptake + sTg > 215 ng/mL, n = 24), group 3 (no 131I uptake, n = 12). Disease-specific survival (DSS) was estimated using the Kaplan–Meier method. Factors predicting the outcome were evaluated using Cox proportional hazard regression analysis. The age of patients (p = 0.04), frequency of follicular thyroid carcinoma (p = 0.002), tumor size (p < 0.001), and number of multiple metastatic sites (p = 0.004) differed significantly among the groups. With a median follow-up after surgery of 72 months, the 5- and 10-year DSSs for all patients were 84 and 69 %, respectively. The predictors of survival were age (p = 0.004), symptoms at the time of presentation (p = 0.045), histology (p = 0.01), sites of metastasis (p = 0.03), and 131I avidity and sTg level at the time of metastasis (p = 0.002). In the multivariate analysis, age, histology, and 131I avidity and sTg level at the time of metastasis remained significant factors for survival. Certain DTC patients with distant metastasis demonstrate favorable outcomes dependent on age, histology, and 131I avidity and sTg level at the time of metastasis.Funding Information
- Korean Foundation for Cancer Research (CB‐2011‐03‐02)
This publication has 27 references indexed in Scilit:
- The Impact of Distant Metastases at Presentation on Prognosis in Patients with Differentiated Carcinoma of the Thyroid GlandThyroid®, 2012
- Revised American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid CancerThyroid®, 2009
- Metastatic differentiated thyroid carcinoma: clinical management and outcome of disease in patients with initial and late distant metastasesNuclear Medicine Communications, 2009
- The Importance of Age over Radioiodine Avidity as a Prognostic Factor in Differentiated Thyroid Carcinoma with Distant MetastasesThyroid®, 2009
- European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epitheliumActa Endocrinologica, 2006
- Management of brain metastases from thyroid carcinomaCancer, 2003
- Relationship Between Tumor Burden and Serum Thyroglobulin Level in Patients with Papillary and Follicular Thyroid CarcinomaThyroid®, 2002
- Survival and Therapeutic Modalities in Patients with Bone Metastases of Differentiated Thyroid CarcinomasJournal of Clinical Endocrinology & Metabolism, 2001
- Current Approaches to Primary Therapy for Papillary and Follicular Thyroid CancerJournal of Clinical Endocrinology & Metabolism, 2001
- Prognosis and Treatment of Brain Metastases in Thyroid CarcinomaJournal of Clinical Endocrinology & Metabolism, 1997