Abstract
BackgroundThyroid carcinoma generally responds well to treatment and spinal metastasis is an uncommon feature. Many studies have looked at the management of spinal metastasis and proposed treatments, plans and algorithms. These range from well-established methods to potentially novel alternatives including bisphosphonates and vascular endothelial growth factor (VEGF) therapy, amongst others.The purposes of this systematic review of the literature are twofold. Firstly we sought to analyse the proposed management options in the literature. Then, secondly, we endeavoured to make recommendations that might improve the prognosis of patients with spinal metastasis from thyroid carcinomas.MethodsWe conducted an extensive electronic literature review regarding the management of spinal metastasis of thyroid cancer.ResultsWe found that there is a tangible lack of studies specifically analysing the management of spinal metastasis in thyroid cancer. Our results show that there are palliative and curative options in the management of spinal metastasis, in the forms of radioiodine ablation, surgery, selective embolisation, bisphosphonates and more recently the VEGF receptor targets.ConclusionsThe management of spinal metastasis from thyroid cancer should be multi-disciplinary. There is an absence; it seems, of a definitive protocol for treatment. Research shows increased survival with 131I avidity and complete bone metastasis resection. Early detection and treatment therefore are crucial. Studies suggest in those patients below the age of 45 years that treatment should be aggressive, and aim for cure. In those patients in whom curative treatment is not an option, palliative treatments are available.
Highlights
Thyroid cancer is uncommon, accounting for roughly 1% of all new malignant disease, about 0Á5% of cancers in men and 1Á5% in women [1,2,3,4]
We reviewed the references of the literature initially found, in order to avoid neglecting relevant articles that were missed by our search criteria
In this systematic review we focused on therapeutic management of spinal metastasis in thyroid cancer with reference to survival time, pain management and prognostic indicators
Summary
Thyroid cancer is uncommon, accounting for roughly 1% of all new malignant disease, about 0Á5% of cancers in men and 1Á5% in women [1,2,3,4] It affects approximately 1900 people in the UK each year, but its incidence has been increasing for decades [5,6,7,8]. Many studies have looked at the management of spinal metastasis and proposed treatments, plans and algorithms. These range from well-established methods to potentially novel alternatives including bisphosphonates and vascular endothelial growth factor (VEGF) therapy, amongst others. Secondly, we endeavoured to make recommendations that might improve the prognosis of patients with spinal metastasis from thyroid carcinomas
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