Abstract
Background. The aims of this study were to analyze the clinical characteristics of SPM in patients with well-differentiated thyroid cancer and to determine the long-term prognosis in patients with double malignancies. Materials and Methods. We retrospectively analyzed 2,864 patients with well-differentiated thyroid cancer and a mean age of 44.0 ± 14.4 years. Of these, 200 (7.0%) were diagnosed with SPM, 115 of which were diagnosed with metachronous SPM. Results. Of 2,864 patients, 163 (5.7%) patients died of thyroid cancer and 301 (10.5%) died of any cause by the end of the follow-up period. Multivariate analysis identified age, SPM, external radiotherapy, TNM stage, and postoperative serum Tg level to be factors independently associated with decreased survival. Of 200 patients with SPM, 74 (37.0%) died. In comparison to the anachronous and synchronous groups, the metachronous SPM group had a higher mean age; more advanced tumor, node, and metastasis stage; lower remission rate; higher postoperative radioactive iodide (131I) accumulated dose; a higher proportion of patients who underwent external radiotherapy; and higher thyroid cancer and total mortality rates. Conclusions. Patients with well-differentiated thyroid carcinoma and metachronous SPM had worse prognoses compared to patients without SPM.
Highlights
Thyroid cancer is the most common endocrine cancer and one of the malignancies with the most rapidly increasing frequency over the last few decades [1,2,3]
The second primary malignancy (SPM) group had a greater proportion of men, higher mean age, more advanced TNM stage, higher nonremission rate, higher 131I accumulated dose, higher proportion of patients who underwent external radiotherapy, and higher total and thyroid cancer mortality rates
SPM, external radiotherapy, TNM stage, and postoperative serum Tg level were significantly higher in the mortality group
Summary
Thyroid cancer is the most common endocrine cancer and one of the malignancies with the most rapidly increasing frequency over the last few decades [1,2,3]. The purpose of this study was to analyze the clinical characteristics of SPM in patients with welldifferentiated thyroid cancer of follicular cell origin and to determine the long-term prognosis in patients with double malignancies. The aims of this study were to analyze the clinical characteristics of SPM in patients with well-differentiated thyroid cancer and to determine the long-term prognosis in patients with double malignancies. In comparison to the anachronous and synchronous groups, the metachronous SPM group had a higher mean age; more advanced tumor, node, and metastasis stage; lower remission rate; higher postoperative radioactive iodide (131I) accumulated dose; a higher proportion of patients who underwent external radiotherapy; and higher thyroid cancer and total mortality rates. Patients with well-differentiated thyroid carcinoma and metachronous SPM had worse prognoses compared to patients without SPM
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