THYROID CANCER
PROGNOSIS
OF PATIENTS WITH METASTATIC DIFFERENTIATED THYROID CANCER (DTC)
Patients
with distant metastatic disease have a reasonable life expectancy and survival
is measured in many years. The most frequent sites of distant metastases are
lung, bone, brain, liver, and skin. In a recent study (*) median overall
survival (OS) was 10.45 years and the median progression-free (PFS) survival
was 3.65 years. A strong correlation was found between OS and PFS. At a median
follow-up of 6.9 years, 68 % of patients with pulmonary metastases had progression
of the disease and 46 % had died. Prognosis is better for younger patients with
low disease burden (**).
Factors
associated with a poorer prognosis (as evidenced by shorter PFS) include:
·
Older
age (> 45 years)
·
High
fluorodeoxyglucose (FDG) avidity of metastatic foci
·
Aggressive
tumor histology/biology, such as:
o
Poorly
differentiated thyroid cancer
o
Hürthle-cell histology
·
Poor
avidity to radioactive iodine (RAI)
·
Disease
refractory to RAI therapy
·
Initial
high stage
·
Male
sex
·
Metastatic
foci > 1 cm
·
Multiorgan
metastatic disease involving many organs
*Thyroid
2016,26(4):518
**J Clin
Endocrinol Metab 2006;91 (8):2892
Σχόλια
Δημοσίευση σχολίου