Abstract

Background. Bone is a frequent site of metastasis from thyroid carcinoma, but prognostic factors for patients who have surgery for thyroid carcinoma bone metastases are poorly understood. Methods. A retrospective review at a single institution identified 41 patients that underwent surgery in the appendicular skeleton for thyroid carcinoma bone metastasis from 1988 to 2011. Results. Overall patient survival probability by Kaplan-Meier analysis after surgery for bone metastasis was 72% at 1 year, 29% at 5 years, and 20% at 8 years. Patients who had their tumor excised (P = 0.001) or presented with solitary bone involvement had a lower risk of death following surgery adjusting for age and gender. Disease progression at the surgery site occurred more frequently with a histological diagnosis of follicular carcinoma compared with other subtypes (P = 0.023). Multivariate analysis showed that tumor subtype, chemotherapy, and preoperative radiation treatment had no effect on survival after surgery. Patients treated with radioactive iodine had better survival following thyroidectomy, but not following surgery for bone metastases. Conclusions. For patients undergoing surgery for thyroid cancer bone metastasis, resection of the bone metastasis, if possible, has a survival benefit.

Highlights

  • Distant metastases are found at diagnosis or followup in 10%–15% of patients with differentiated thyroid cancer [1,2,3,4]

  • Patients with a solitary bone metastasis at the time of presentation showed a trend for improved survival relative to those with multiple bone metastases, not statistically significant (P = 0.07)

  • The development of osseous metastases from thyroid carcinoma is associated with poorer patient survival and prognosis

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Summary

Introduction

Distant metastases are found at diagnosis or followup in 10%–15% of patients with differentiated thyroid cancer [1,2,3,4]. Several studies have examined the prognostic factors and treatment outcomes for bone metastases from thyroid cancer, but few have evaluated the effects of surgical management [2, 6,7,8]. Patients with BMs from thyroid carcinoma generally have better survival than some other carcinomas that frequently metastasize to bone, such as lung and renal cell carcinoma [3,4,5, 7, 13,14,15]. Bone is a frequent site of metastasis from thyroid carcinoma, but prognostic factors for patients who have surgery for thyroid carcinoma bone metastases are poorly understood. Overall patient survival probability by Kaplan-Meier analysis after surgery for bone metastasis was 72% at 1 year, 29% at 5 years, and 20% at 8 years. For patients undergoing surgery for thyroid cancer bone metastasis, resection of the bone metastasis, if possible, has a survival benefit

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