Metastatic differentiated thyroid carcinoma: Clinicopathological profile and outcome in an iodine deficient area

被引:0
作者
Mishra A. [1 ]
Mishra S.K. [1 ]
Agarwal A. [1 ]
Das B.K. [2 ]
Agarwal G. [2 ]
Gambhir S. [2 ]
机构
[1] Department of Endocrine Surgery, S. Gandhi Post-Grad. Inst. Med. Sci., Lucknow, 226014, Raebareli Road
[2] Department of Nuclear Medicine, S. Gandhi Post-Grad. Inst. Med. Sci., Lucknow, 226014, Raebareli Road
关键词
Carcinoma; Iodine; Nuclear Medicine; Thyroid Carcinoma; Iodine Deficient;
D O I
10.1007/s00268-001-0198-x
中图分类号
学科分类号
摘要
Reports on metastatic differentiated carcinoma in endemic goiter regions are scarce. The aim of this study was to look into the clinicopathological profile and outcome of patients with metastatic differentiated thyroid carcinoma (DTC) of endemic origin. This was a retrospective study of 28 cases of metastatic DTC out of a total of 140 DTC patients managed between 1990 and June 1999. Demographic data, clinicopathological profile, operative and radioiodine ablation therapy details, and follow-up findings were noted. The overall incidence of distant metastases in our series was 20%. Mean age was 48.5 ± 12.8 years (32.1% patients were < 45 years). Most metastases were detected synchronously (85.7%) and were multiple, with the skeletal system being the commonly affected site. Out of 22 cases having skeletal metastases, 6 patients were young (< 45 years). Though most patients with skeletal metastases had follicular carcinoma (FTC), 4 cases had papillary thyroid cancer (PTC). Near total or total thyroidectomy was done in 26 cases. Sixteen patients required regional lymph node dissection. Resection of metastases was performed in 9 cases. Histopathological diagnosis was PTC, FTC, and poorly differentiated carcinoma in 32.1%, 50.0%, and 17.9% of cases, respectively. Most patients had good symptomatic palliation following administration of I131 therapy. In 17.9% of cases there were locoregional recurrences. There was an overall 28.6% mortality. Two patients expired in the perioperative period. Six others died in follow-up (all within 3-9 months). In contrast to iodine sufficient regions, the incidence of metastases was high; the majority of cases had synchronous, symptomatic skeletal metastases. Skeletal metastases were not infrequent even in cases of PTC and in young patients. One-third of the cases were young. Though survival was poor despite aggressive management, significant symptomatic palliation could be achieved in most cases.
引用
收藏
页码:153 / 157
页数:4
相关论文
共 23 条
[1]  
Beierwaltes W.H., Nishiyama R.H., Thompson N.W., Copp J.E., Kubo A., Survival time and "cure" in papillary and follicular thyroid carcinoma with distant metastases: Statistics following University of Michigan therapy, J. Nucl. Med., 23, (1982)
[2]  
Buckwalter J.A., Thomas C.G., Selection of surgical treatment for well differentiated thyroid carcinoma, Ann. Surg., 176, (1972)
[3]  
Marcocci C., Pacini F., Elisei R., Schipani E., Ceccarelli C., Miccoli P., Arganini M., Pinchera A., Clinical and biologic behavior of bone metastases from differentiated thyroid carcinoma, Surgery, 106, (1989)
[4]  
Schlumberger M., Tubiana M., De Vathaire F., Hill C., Gardit P., Travagli J.P., Fragui P., Lumbroso J.D., Caillon B., Parmentier C., Long term results of treatment of 283 patients with lung and bone metastases from differentiated thyroid carcinoma, J. Clin. Endocrinol. Metab., 63, (1986)
[5]  
Ruegemer J.J., Hay I.D., Bergstralh E.J., Ryan J.J., Offord K.P., Gorman C.A., Distant metastases in differentiated thyroid carcinoma: A multivariate analysis of prognostic variables, J. Clin. Endocrinol. Metab., 67, (1988)
[6]  
McCormack K.R., Bone metastases from thyroid carcinoma, Cancer, 19, (1966)
[7]  
Nagamine Y., Suzuki J., Katakura R., Yoshimoto T., Matoba N., Takaya K., Skull metastases of thyroid carcinoma. Study of 12 cases, J. Neurosurg., 63, (1985)
[8]  
Tubiana M., Schlumberger M., Rougier P., Laplanche A., Benhaman E., Gardit P., Caillon B., Travagli J.P., Parmentier C., Long term results and prognostic factors in patients with differentiated thyroid carcinoma, Cancer, 55, (1985)
[9]  
Pacini F., Cetani F., Miccoli P., Mancusi F., Ceccarelli C., Lippi F., Martino E., Pinchera A., Outcome of 309 patients with metastatic differentiated thyroid carcinoma treated with radioiodine, World J. Surg., 18, (1994)
[10]  
Pacini F., Lippi F., Formica N., Elisei R., Anelli S., Ceccarelli C., Pinchera A., Therapeutic doses of iodine- 131 reveal undiagnosed metastases in thyroid cancer patients with detectable serum thyroglobulin levels, J. Nucl. Med., 28, (1987)