LONG-TERM OUTCOMES AND PROGNOSTIC FACTORS IN PATIENTS WITH DIFFERENTIATED THYROID CANCER AND DISTANT METASTASES
Distant metastatic spread is the most frequent cause of thyroid cancer-related death. The objective of this study was to evaluate overall and disease-related survival of patients with differentiated thyroid cancer (DTC) and distant metastases (DM) attending a single medical center and to investigate...
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| Veröffentlicht in: | Endocrine practice 2017-10, Vol.23 (10), p.1193-1200 |
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| creator | Hirsch, Dania Levy, Sigal Tsvetov, Gloria Gorshtein, Alexander Slutzky-Shraga, Ilana Akirov, Amit Robenshtok, Eyal Shimon, Ilan Benbassat, Carlos A |
| description | Distant metastatic spread is the most frequent cause of thyroid cancer-related death. The objective of this study was to evaluate overall and disease-related survival of patients with differentiated thyroid cancer (DTC) and distant metastases (DM) attending a single medical center and to investigate variables predictive of better long-term outcomes.
The Rabin Medical Center Thyroid Cancer Registry was searched for patients with DM from DTC.
The cohort included 138 patients (58.7% female) diagnosed at age 54.7 ± 19.5 years. Mean primary tumor size was 33.9 ± 26 mm. Most patients (57.7%) were stage T3/T4; 48.7% had extrathyroidal extension; 53.5% had lymph node metastases. Histopathology yielded papillary and follicular thyroid carcinoma in 66.7% and 13.8%, respectively, and intermediate/poorly differentiated carcinoma in 19.6%. All but 2 patients underwent total thyroidectomy, and 133/138 (96.4%) received radioactive iodine (RAI) therapy. DM were synchronous in 55.1%. The mean follow-up was 8.2 years from detection of metastases. The common sites of metastases were the lungs (85.6% of patients), bones (39.9%), brain (5.8%) and liver (3.6%). At last follow-up, resolution was documented in 24.6% of patients, improvement/stable disease in 31.6%, and structurally progressive disease in 43.4%. By the end of the study, 40.6% of patients died, 23.2% of DTC. Improved overall survival and disease progression were associated with younger age, lung-only DM, and metastatic RAI avidity.
Patients with DTC and DM treated by standard-of-care approaches frequently achieve favorable long-term outcomes. Novel therapies might be necessary in only a minority of these patients, and the reported prognostic factors can aid in their identification.
CR = complete response; DM = distant metastases; DTC = differentiated thyroid cancer; ETE = extra-thyroidal extension; M0 = detected during follow-up; M1 = detected at diagnosis; MSKCC = Memorial Sloan Kettering Cancer Center; NED = no evidence of disease; OS = overall survival; PFS = progression free survival; PTC = papillary thyroid cancer; RAI = radioactive iodine; Tg = thyroglobulin. |
| doi_str_mv | 10.4158/EP171924.OR |
| format | Article |
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The Rabin Medical Center Thyroid Cancer Registry was searched for patients with DM from DTC.
The cohort included 138 patients (58.7% female) diagnosed at age 54.7 ± 19.5 years. Mean primary tumor size was 33.9 ± 26 mm. Most patients (57.7%) were stage T3/T4; 48.7% had extrathyroidal extension; 53.5% had lymph node metastases. Histopathology yielded papillary and follicular thyroid carcinoma in 66.7% and 13.8%, respectively, and intermediate/poorly differentiated carcinoma in 19.6%. All but 2 patients underwent total thyroidectomy, and 133/138 (96.4%) received radioactive iodine (RAI) therapy. DM were synchronous in 55.1%. The mean follow-up was 8.2 years from detection of metastases. The common sites of metastases were the lungs (85.6% of patients), bones (39.9%), brain (5.8%) and liver (3.6%). At last follow-up, resolution was documented in 24.6% of patients, improvement/stable disease in 31.6%, and structurally progressive disease in 43.4%. By the end of the study, 40.6% of patients died, 23.2% of DTC. Improved overall survival and disease progression were associated with younger age, lung-only DM, and metastatic RAI avidity.
Patients with DTC and DM treated by standard-of-care approaches frequently achieve favorable long-term outcomes. Novel therapies might be necessary in only a minority of these patients, and the reported prognostic factors can aid in their identification.
CR = complete response; DM = distant metastases; DTC = differentiated thyroid cancer; ETE = extra-thyroidal extension; M0 = detected during follow-up; M1 = detected at diagnosis; MSKCC = Memorial Sloan Kettering Cancer Center; NED = no evidence of disease; OS = overall survival; PFS = progression free survival; PTC = papillary thyroid cancer; RAI = radioactive iodine; Tg = thyroglobulin.</description><identifier>ISSN: 1530-891X</identifier><identifier>EISSN: 1934-2403</identifier><identifier>DOI: 10.4158/EP171924.OR</identifier><identifier>PMID: 28704099</identifier><language>eng</language><publisher>United States: Elsevier Limited</publisher><subject>Adult ; Aged ; Bones ; Carcinoma, Papillary, Follicular - diagnosis ; Carcinoma, Papillary, Follicular - mortality ; Carcinoma, Papillary, Follicular - pathology ; Disease Progression ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Iodine ; Lungs ; Male ; Medical prognosis ; Metastasis ; Middle Aged ; Multivariate analysis ; Neoplasm Metastasis ; Patients ; Prognosis ; Survival Analysis ; Thyroid cancer ; Thyroid Neoplasms - diagnosis ; Thyroid Neoplasms - mortality ; Thyroid Neoplasms - pathology ; Variables ; Young Adult</subject><ispartof>Endocrine practice, 2017-10, Vol.23 (10), p.1193-1200</ispartof><rights>Copyright Allen Press Publishing Services Oct 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c317t-c4d6fc3091d5f170148511175afc542521b82908b423d5ad5dffa797bee112293</citedby><cites>FETCH-LOGICAL-c317t-c4d6fc3091d5f170148511175afc542521b82908b423d5ad5dffa797bee112293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1953817548?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>315,782,786,27933,27934,64394,64396,64398,72478</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28704099$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hirsch, Dania</creatorcontrib><creatorcontrib>Levy, Sigal</creatorcontrib><creatorcontrib>Tsvetov, Gloria</creatorcontrib><creatorcontrib>Gorshtein, Alexander</creatorcontrib><creatorcontrib>Slutzky-Shraga, Ilana</creatorcontrib><creatorcontrib>Akirov, Amit</creatorcontrib><creatorcontrib>Robenshtok, Eyal</creatorcontrib><creatorcontrib>Shimon, Ilan</creatorcontrib><creatorcontrib>Benbassat, Carlos A</creatorcontrib><title>LONG-TERM OUTCOMES AND PROGNOSTIC FACTORS IN PATIENTS WITH DIFFERENTIATED THYROID CANCER AND DISTANT METASTASES</title><title>Endocrine practice</title><addtitle>Endocr Pract</addtitle><description>Distant metastatic spread is the most frequent cause of thyroid cancer-related death. The objective of this study was to evaluate overall and disease-related survival of patients with differentiated thyroid cancer (DTC) and distant metastases (DM) attending a single medical center and to investigate variables predictive of better long-term outcomes.
The Rabin Medical Center Thyroid Cancer Registry was searched for patients with DM from DTC.
The cohort included 138 patients (58.7% female) diagnosed at age 54.7 ± 19.5 years. Mean primary tumor size was 33.9 ± 26 mm. Most patients (57.7%) were stage T3/T4; 48.7% had extrathyroidal extension; 53.5% had lymph node metastases. Histopathology yielded papillary and follicular thyroid carcinoma in 66.7% and 13.8%, respectively, and intermediate/poorly differentiated carcinoma in 19.6%. All but 2 patients underwent total thyroidectomy, and 133/138 (96.4%) received radioactive iodine (RAI) therapy. DM were synchronous in 55.1%. The mean follow-up was 8.2 years from detection of metastases. The common sites of metastases were the lungs (85.6% of patients), bones (39.9%), brain (5.8%) and liver (3.6%). At last follow-up, resolution was documented in 24.6% of patients, improvement/stable disease in 31.6%, and structurally progressive disease in 43.4%. By the end of the study, 40.6% of patients died, 23.2% of DTC. Improved overall survival and disease progression were associated with younger age, lung-only DM, and metastatic RAI avidity.
Patients with DTC and DM treated by standard-of-care approaches frequently achieve favorable long-term outcomes. Novel therapies might be necessary in only a minority of these patients, and the reported prognostic factors can aid in their identification.
CR = complete response; DM = distant metastases; DTC = differentiated thyroid cancer; ETE = extra-thyroidal extension; M0 = detected during follow-up; M1 = detected at diagnosis; MSKCC = Memorial Sloan Kettering Cancer Center; NED = no evidence of disease; OS = overall survival; PFS = progression free survival; PTC = papillary thyroid cancer; RAI = radioactive iodine; Tg = thyroglobulin.</description><subject>Adult</subject><subject>Aged</subject><subject>Bones</subject><subject>Carcinoma, Papillary, Follicular - diagnosis</subject><subject>Carcinoma, Papillary, Follicular - mortality</subject><subject>Carcinoma, Papillary, Follicular - pathology</subject><subject>Disease Progression</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Iodine</subject><subject>Lungs</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Neoplasm Metastasis</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Survival Analysis</subject><subject>Thyroid cancer</subject><subject>Thyroid Neoplasms - diagnosis</subject><subject>Thyroid Neoplasms - mortality</subject><subject>Thyroid Neoplasms - pathology</subject><subject>Variables</subject><subject>Young Adult</subject><issn>1530-891X</issn><issn>1934-2403</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkUtLw0AUhQdRfFRX7mXAjSDRufMwM8uQTNuBNlOSEXUV0jxAaU1N7MJ_7_ioC1f3XPg493APQudAbjgIeasXEIKi_MZme-gYFOMB5YTtey0YCaSCxyN0MgwvhFCiQB6iIypDwolSx6ib2XQSOJ3Nsb13sZ3rHEdpgheZnaQ2dybG4yh2NsuxSfEickanLscPxk1xYsZjnfndRE4n2E2fMmsSHEdprLNvl8TkLkodnmsXeZXr_BQdtOVqaM5-5wjdj7WLp8HMTkwczYKKQfgeVLy-ayvm49aihZAAlwIAQlG2leBUUFhKqohccspqUdaibtsyVOGyaQAoVWyErn58N333tm2G92L9PFTNalW-Nt12KEAJ5jEhQ49e_kNfum3_6tN9U9Jf5dJT1z9U1XfD0Ddtsemf12X_UQApvnoodj0UNvP0xa_ndrlu6j9293j2CS1ed9Q</recordid><startdate>201710</startdate><enddate>201710</enddate><creator>Hirsch, Dania</creator><creator>Levy, Sigal</creator><creator>Tsvetov, Gloria</creator><creator>Gorshtein, Alexander</creator><creator>Slutzky-Shraga, Ilana</creator><creator>Akirov, Amit</creator><creator>Robenshtok, Eyal</creator><creator>Shimon, Ilan</creator><creator>Benbassat, Carlos A</creator><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>201710</creationdate><title>LONG-TERM OUTCOMES AND PROGNOSTIC FACTORS IN PATIENTS WITH DIFFERENTIATED THYROID CANCER AND DISTANT METASTASES</title><author>Hirsch, Dania ; Levy, Sigal ; Tsvetov, Gloria ; Gorshtein, Alexander ; Slutzky-Shraga, Ilana ; Akirov, Amit ; Robenshtok, Eyal ; Shimon, Ilan ; Benbassat, Carlos A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c317t-c4d6fc3091d5f170148511175afc542521b82908b423d5ad5dffa797bee112293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Bones</topic><topic>Carcinoma, Papillary, Follicular - diagnosis</topic><topic>Carcinoma, Papillary, Follicular - mortality</topic><topic>Carcinoma, Papillary, Follicular - pathology</topic><topic>Disease Progression</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Iodine</topic><topic>Lungs</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Neoplasm Metastasis</topic><topic>Patients</topic><topic>Prognosis</topic><topic>Survival Analysis</topic><topic>Thyroid cancer</topic><topic>Thyroid Neoplasms - diagnosis</topic><topic>Thyroid Neoplasms - mortality</topic><topic>Thyroid Neoplasms - pathology</topic><topic>Variables</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hirsch, Dania</creatorcontrib><creatorcontrib>Levy, Sigal</creatorcontrib><creatorcontrib>Tsvetov, Gloria</creatorcontrib><creatorcontrib>Gorshtein, Alexander</creatorcontrib><creatorcontrib>Slutzky-Shraga, Ilana</creatorcontrib><creatorcontrib>Akirov, Amit</creatorcontrib><creatorcontrib>Robenshtok, Eyal</creatorcontrib><creatorcontrib>Shimon, Ilan</creatorcontrib><creatorcontrib>Benbassat, Carlos A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Endocrine practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hirsch, Dania</au><au>Levy, Sigal</au><au>Tsvetov, Gloria</au><au>Gorshtein, Alexander</au><au>Slutzky-Shraga, Ilana</au><au>Akirov, Amit</au><au>Robenshtok, Eyal</au><au>Shimon, Ilan</au><au>Benbassat, Carlos A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>LONG-TERM OUTCOMES AND PROGNOSTIC FACTORS IN PATIENTS WITH DIFFERENTIATED THYROID CANCER AND DISTANT METASTASES</atitle><jtitle>Endocrine practice</jtitle><addtitle>Endocr Pract</addtitle><date>2017-10</date><risdate>2017</risdate><volume>23</volume><issue>10</issue><spage>1193</spage><epage>1200</epage><pages>1193-1200</pages><issn>1530-891X</issn><eissn>1934-2403</eissn><abstract>Distant metastatic spread is the most frequent cause of thyroid cancer-related death. The objective of this study was to evaluate overall and disease-related survival of patients with differentiated thyroid cancer (DTC) and distant metastases (DM) attending a single medical center and to investigate variables predictive of better long-term outcomes.
The Rabin Medical Center Thyroid Cancer Registry was searched for patients with DM from DTC.
The cohort included 138 patients (58.7% female) diagnosed at age 54.7 ± 19.5 years. Mean primary tumor size was 33.9 ± 26 mm. Most patients (57.7%) were stage T3/T4; 48.7% had extrathyroidal extension; 53.5% had lymph node metastases. Histopathology yielded papillary and follicular thyroid carcinoma in 66.7% and 13.8%, respectively, and intermediate/poorly differentiated carcinoma in 19.6%. All but 2 patients underwent total thyroidectomy, and 133/138 (96.4%) received radioactive iodine (RAI) therapy. DM were synchronous in 55.1%. The mean follow-up was 8.2 years from detection of metastases. The common sites of metastases were the lungs (85.6% of patients), bones (39.9%), brain (5.8%) and liver (3.6%). At last follow-up, resolution was documented in 24.6% of patients, improvement/stable disease in 31.6%, and structurally progressive disease in 43.4%. By the end of the study, 40.6% of patients died, 23.2% of DTC. Improved overall survival and disease progression were associated with younger age, lung-only DM, and metastatic RAI avidity.
Patients with DTC and DM treated by standard-of-care approaches frequently achieve favorable long-term outcomes. Novel therapies might be necessary in only a minority of these patients, and the reported prognostic factors can aid in their identification.
CR = complete response; DM = distant metastases; DTC = differentiated thyroid cancer; ETE = extra-thyroidal extension; M0 = detected during follow-up; M1 = detected at diagnosis; MSKCC = Memorial Sloan Kettering Cancer Center; NED = no evidence of disease; OS = overall survival; PFS = progression free survival; PTC = papillary thyroid cancer; RAI = radioactive iodine; Tg = thyroglobulin.</abstract><cop>United States</cop><pub>Elsevier Limited</pub><pmid>28704099</pmid><doi>10.4158/EP171924.OR</doi><tpages>8</tpages></addata></record> |
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| subjects | Adult Aged Bones Carcinoma, Papillary, Follicular - diagnosis Carcinoma, Papillary, Follicular - mortality Carcinoma, Papillary, Follicular - pathology Disease Progression Disease-Free Survival Female Follow-Up Studies Humans Iodine Lungs Male Medical prognosis Metastasis Middle Aged Multivariate analysis Neoplasm Metastasis Patients Prognosis Survival Analysis Thyroid cancer Thyroid Neoplasms - diagnosis Thyroid Neoplasms - mortality Thyroid Neoplasms - pathology Variables Young Adult |
| title | LONG-TERM OUTCOMES AND PROGNOSTIC FACTORS IN PATIENTS WITH DIFFERENTIATED THYROID CANCER AND DISTANT METASTASES |
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