Abstract #1001: Multiple Distant Metastasis of Papillary Thyroid Cancer to Skeletal Muscles

AbstractThis study of 542 patients with follicular thyroid cancer, 366 patients with the follicular variant and 1452 patients with the classical variant of papillary thyroid cancer, and 819 patients with sporadic medullary thyroid cancer operated at a tertiary referral center aimed to determine risk patterns of distant metastasis for each tumor entity, which are ill-defined. On multivariable logistic regression analyses, lymph node metastasis consistently emerged as an independent risk factor of distant metastasis, yielding odds ratios (ORs) of 2.4 and 2.8 for follicular thyroid cancer and the follicular variant of papillary thyroid cancer, and ORs of 5.9 and 6.4 for the classical variant of papillary thyroid cancer and sporadic medullary thyroid cancer. Another independent risk factor consistently associated with distant metastasis, most strongly in follicular thyroid cancer and the follicular variant of papillary thyroid cancer (OR 3.5 and 4.0), was patient age >60 years. Altogether, 2 distinct risk patterns of distant metastasis were identified, which were modulated by other cancer type-dependent risk factors: one with lymph node metastasis as leading component (classical variant of papillary thyroid cancer and sporadic medullary thyroid cancer), and another one with age as leading component (follicular thyroid cancer and the follicular variant of papillary thyroid cancer). Distant metastasis was exceptional in node-negative patients with sporadic medullary thyroid cancer (1.7%) and the classical variant of papillary thyroid cancer (1.4%), and infrequent in node-negative patients with the follicular variant of papillary thyroid cancer (4.4%). These findings delineate windows of opportunity for early surgical intervention before distant metastasis has occurred.

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A Child with Papillary Thyroid Cancer and Locally Advanced Disease but No Distant Metastasis

Thyroid Cancer ◽

10.1007/978-3-319-22401-5_12 ◽

2016 ◽

pp. 111-118

Author(s):

Sarah J. Bottomley ◽

Steven G. Waguespack

Keyword(s):

Thyroid Cancer ◽

Papillary Thyroid Cancer ◽

Distant Metastasis ◽

Advanced Disease ◽

Locally Advanced ◽

Papillary Thyroid ◽

Locally Advanced Disease

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Site-Specific Metastasis and Survival in Papillary Thyroid Cancer: The Importance of Brain and Multi-Organ Disease

Cancers ◽

10.3390/cancers13071625 ◽

2021 ◽

Vol 13 (7) ◽

pp. 1625

Author(s):

Eman A. Toraih ◽

Mohammad H. Hussein ◽

Mourad Zerfaoui ◽

Abdallah S. Attia ◽

Assem Marzouk Ellythy ◽

...

Keyword(s):

Thyroid Cancer ◽

Papillary Thyroid Cancer ◽

Distant Metastasis ◽

Cox Regression ◽

Distant Metastases ◽

Multiple Organ ◽

Organ Involvement ◽

Papillary Thyroid ◽

Cancer Specific Survival ◽

Organ Metastasis

Introduction—heterogeneity in clinical outcomes and survival was observed in patients with papillary thyroid cancer (PTC) and distant metastases. Here, we investigated the effect of distant metastases sites on survival in PTC patients. Methods—patients with a diagnosis of PTC and known metastases were identified using the Surveillance, Epidemiology, and End Results database (1975–2016). Univariate and multivariate Cox regression analyses were performed to analyze the effect of distant metastases sites on thyroid cancer-specific survival (TCSS) and overall survival (OS). Results—from 89,694 PTC patients, 1819 (2%) developed distant metastasis at the initial diagnosis, of whom 26.3% presented with the multiple-organ disease. The most common metastatic sites were lung (53.4%), followed by bone (28.1%), liver (8.3%), and brain (4.7%). In metastatic patients, thyroid cancer-specific death accounted for 73.2%. Kaplan–Meier curves showed decreased OS in patients with metastases to the brain (median OS = 5 months) and liver (median OS = 6 months) compared to lung (median OS = 10 months) and bone (median OS = 23 months). Moreover, multiple organ metastasis had a higher mortality rate (67.4%) compared to single organ metastasis (51.2%, p < 0.001). Using multivariate analysis, risk factors that significantly influence TCSS and OS were male gender (HR = 1.86, 95% CI = 1.17–2.94, p < 0.001, and HR = 1.90, 95% CI = 1.40–2.57, p = 0.009), higher tumor grade (HR = 7.31, 95% CI = 2.13–25.0, p < 0.001 and HR = 4.76, 95% CI = 3.93–5.76, p < 0.001), multiple organ involvement (HR = 6.52, 95% CI = 1.50–28.39, p = 0.026 and HR = 5.08, 95% CI = 1.21–21.30, p = 0.013), and brain metastasis (HR = 1.82, 95% CI = 1.15–2.89, p < 0.001 and HR = 4.21, 95% CI = 2.20–8.07, p = 0.010). Conclusion—the pattern of distant metastatic organ involvement was associated with variability in OS in PTC. Multi-organ metastasis and brain involvement are associated with lower survival rates in PTC. Knowledge of the patterns of distant metastasis is crucial to personalize the treatment and follow-up strategies.

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Outcomes of thyrotropin alfa vs. levothyroxine withdrawal-aided radioiodine therapy for distant metastasis of papillary thyroid cancer

Thyroid ◽

10.1089/thy.2021.0013 ◽

2021 ◽

Author(s):

Joana Simoes-Pereira ◽

Teresa C. Ferreira ◽

Edward Limbert ◽

Branca Maria Cavaco ◽

Valeriano Leite

Keyword(s):

Thyroid Cancer ◽

Papillary Thyroid Cancer ◽

Distant Metastasis ◽

Radioiodine Therapy ◽

Papillary Thyroid

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The Age Threshold of the 8th Edition AJCC Classification Is Useful for Indicating Patients with Aggressive Papillary Thyroid Cancer in Clinical Practice .

10.21203/rs.3.rs-35309/v1 ◽

2020 ◽

Author(s):

Krzysztof Kaliszewski ◽

Dorota Diakowska ◽

Łukasz Nowak ◽

Beata Wojtczak ◽

Jerzy Rudnicki

Keyword(s):

Overall Survival ◽

Thyroid Cancer ◽

Clinical Practice ◽

Tumor Progression ◽

Papillary Thyroid Cancer ◽

Distant Metastasis ◽

Disease Free Survival ◽

Papillary Thyroid ◽

Free Survival ◽

Younger Patients

Abstract Background: Papillary thyroid cancer (PTC) is unique among cancers in that patient age is a consideration in staging. One of the most important modifications in the 8th Edition of the American Joint Committee on Cancer (AJCC) classification, which was introduced in 2018, was to increase the age cutoff for risk stratification in PTC from 45 to 55 years. However, whether this cutoff is useful in clinical practice remains controversial. In the present study, we assessed how well this new age threshold stratifies patients with aggressive PTC.Methods: We retrospectively analyzed the clinicopathological features and overall survival rate of 523 patients with PTC admitted to and surgically treated at a single surgical center. We divided the patients into two groups according to age at PTC diagnosis: ≥55 years and <55 years. Results: We found that the rates of tumor progression, lymph node metastasis (LNM) and distant metastasis were significantly higher in patients ≥55 years than in those <55 years; consequently, TNM stages were significantly higher in older than in younger patients (p<0.05 for all parameters). The risk of tumor progression (T3+T4) was nearly two-fold higher and the risk of LNM (N1) more than four-fold higher in older than in younger patients (p<0.05 for both). No patients <55 years old but 19 patients >55 years old (9.8% of the total group) showed distant metastasis. The rates of microcalcification, vascular and capsular invasion, extrathyroidal extension, irregular tumor shape, multifocality, bilaterality and multiplicity of foci were significantly higher in older than in younger patients (p<0.05 for all). The rate of disease-free survival was significantly lower in older (86.6%) than in younger (98.7%) patients (p<0.0001), and the rate of overall survival was significantly lower in older (90.3%) than in younger (99.4%) patients (p<0.0001).Conclusions: PTC is more aggressive in patients aged ≥ 55 years than in their younger counterparts. This age therefore effectively stratifies PTC patients with a poor prognosis, indicating it is likely to be useful in clinical practice.

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