Brain Metastases from Thyroid Carcinoma: A Retrospective Study of 21 Patients

Figueiredo, B. Henriques de; Godbert, Yann; Soubeyran, Isabelle; Carrat, X; Lagarde, P.; Cazeau, Anne‐Laure; Italiano, Antoîne; Sargos, P.; Kantor, G.; Loiseau, Hugues; Bonichon, F.

doi:10.1089/thy.2013.0061

Cited by 64 publications

(72 citation statements)

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“…In our series, median survival was less than 10 months after CNS metastases’ diagnosis, as observed in two other series (18, 19). Although not statistically significant, patients with incidentally diagnosed M 1 -CNS had a lower survival (incidental CNS diagnosis = 5 months vs patients with neurological symptoms = 8 months; P = 0.911).…”

Section: Discussionsupporting

confidence: 82%

Clinical outcomes of a cohort of patients with central nervous system metastases from thyroid cancer

Simões‐Pereira¹,

Macedo²,

Bugalho³

2016

Endocrine Connections

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IntroductionMetastases to central nervous system (M1-CNS) are rarely reported in thyroid cancer (TC) patients. We aimed to characterize patients with M1-CNS from TC followed in our department.MethodsReview of the medical records of 27 patients with TC-related M1-CNS.ResultsMean age at TC diagnosis was 56.9 ± 19.1 years. Papillary TC (55.6%) was the commonest histological type, followed by poorly differentiated (18.5%), medullary (11.1%), follicular (7.4%) and Hürthle cell (7.4%) carcinomas. Angioinvasion and extrathyroidal extension were observed in a high number of patients. At M1-CNS diagnosis, other distant metastases were already present in 77.8% of the patients. Treatment directed to M1-CNS was offered to 20 (74%) patients: 1 was submitted to surgery, 18 to radiotherapy (either whole-brain radiotherapy or stereotaxic radiosurgery or both) and 4 to surgery and radiotherapy. Four patients received cytotoxic chemotherapy and one was submitted to 131I. Median survival since M1-CNS detection was 5.0 months. The only factor associated with better survival was surgery to brain metastases (P = 0.012).ConclusionsThe management of these patients is very challenging given the inexistence of effective treatments, except for brain surgery in selected cases.

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Section: Discussionsupporting

confidence: 82%

Clinical outcomes of a cohort of patients with central nervous system metastases from thyroid cancer

Simões‐Pereira¹,

Macedo²,

Bugalho³

2016

Endocrine Connections

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“…Surgical resection is the preferred treatment option, unless the lesions are very small and/or mutifocal. Stereotactic radiation can be effective if <3–5 small lesions are present, and whole-brain radiation is required when there are numerous lesions 52–56…”

Section: Adjuvant Treatmentmentioning

confidence: 99%

Hürthle cell carcinoma: current perspectives

Ahmadi¹,

Stang²,

Jiang³

et al. 2016

OTT

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Hürthle cell carcinoma (HCC) can present either as a minimally invasive or as a widely invasive tumor. HCC generally has a more aggressive clinical behavior compared with the other differentiated thyroid cancers, and it is associated with a higher rate of distant metastases. Minimally invasive HCC demonstrates much less aggressive behavior; lesions <4 cm can be treated with thyroid lobectomy alone, and without radioactive iodine (RAI). HCC has been observed to be less iodine-avid compared with other differentiated thyroid cancers; however, recent data have demonstrated improved survival with RAI use in patients with HCC >2 cm and those with nodal and distant metastases. Patients with localized iodine-resistant disease who are not candidates for a wait-and-watch approach can be treated with localized therapies. Systemic therapy is reserved for patients with progressive, widely metastatic HCC.

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“…It is in line with previously published reports that included mostly patients with DTC. [5,[12][13][14] The management of BM from DTC remains undetermined because of a paucity of recent data, and most of the published reports are based on data from old series with symptomatic patients [5]. It is widely thought that chemotherapy is seldom helpful for most type of thyroid cancer and distant metastasis from thyroid cancer, which may support the non-chemotherapy treatments of BM implemented in this study.…”

Section: Discussionmentioning

confidence: 53%

“…The major sites of distant metastases from thyroid cancer are the lung (70%) and bone (20%), and multiple sites are involved in 10-20% of patients at the time of diagnosis [5]. Although patients with M1 thyroid cancer might live for a prolonged period with the disease, the presence of distant metastasis has a significant impact on patient survival [6].…”

Section: Introductionmentioning

confidence: 99%

“…Meanwhile, thyroid cancer represents a brain metastasis (BM) from approximately 1% of all differentiated thyroid cancer (DTC) to around 10% of anaplastic patients. The reported median survival of patients diagnosed with BM varies between 4 months and 33 months [5,7,8]. Because of its rarity, the impact of BM on the survival of patients with DTC is unknown, and there are no clear guidelines for managing patients with BM from DTC.…”

Section: Introductionmentioning

confidence: 99%

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The Largest Known Survival Analysis of Patients With Brain Metastasis From Thyroid Cancer Based on Prognostic Groups

Choi

Kim

Keum

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

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PurposeTo analyze the clinical features and prognostic factors associated with the survival of patients with a very rare occurrence of brain metastasis (BM) from differentiated thyroid cancer (DTC). Methods and MaterialsA total of 37 patients with DTC who were diagnosed with BM between 1995 and 2014 were included. We reviewed the clinical characteristics, treatment modalities, and image findings of BM. Factors associated with survival were evaluated, and the patients were divided into three prognostic groups (Groups A, B, and C) for comparative analysis. ResultsThe median age at BM was 63 years, and the median time from initial thyroid cancer diagnosis to BM was 3.8 years. The median survival and the 1-year actuarial survival rate after BM were 8.8 months and 47%, respectively. According to univariate and multivariate analyses, four good prognostic factors (GPFs) were identified including age 60 years, PS ECOG 2, 3 BM sites, and without extracranial metastasis prior to BM. Three prognostic groups were designed based on age and number of remaining GPFs: patients 60 years of age with at least 2 GPFs (Group A) had the most favorable prognosis with a median survival of 32.8 months; patients 60 years of age with fewer than 2 GPFs and those > 60 years of age with at least 2 GPFs (Group B) had an intermediate prognosis with a median survival of 9.4 months; and patients > 60 years of age with fewer than 2 GPFs (Group C) had the least favorable prognosis with a median survival of 1.5 months. ConclusionsThe survival of patients with BM form DTC differed among the prognostic groups based on the total number of good prognostic factors.

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Brain Metastases from Thyroid Carcinoma: A Retrospective Study of 21 Patients

Abstract: BM from thyroid cancer may have an indolent evolution with survival of one to two years or longer for specific groups of patients. Therefore, aggressive treatment options such as neurosurgery and RT should be strongly considered in patients with good PS.

Cited by 64 publications

References 26 publications

Clinical outcomes of a cohort of patients with central nervous system metastases from thyroid cancer

Clinical outcomes of a cohort of patients with central nervous system metastases from thyroid cancer

Hürthle cell carcinoma: current perspectives

The Largest Known Survival Analysis of Patients With Brain Metastasis From Thyroid Cancer Based on Prognostic Groups

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Brain Metastases from Thyroid Carcinoma: A Retrospective Study of 21 Patients

Abstract: BM from thyroid cancer may have an indolent evolution with survival of one to two years or longer for specific groups of patients. Therefore, aggressive treatment options such as neurosurgery and RT should be strongly considered in patients with good PS.

Cited by 64 publications

References 26 publications

Clinical outcomes of a cohort of patients with central nervous system metastases from thyroid cancer

Clinical outcomes of a cohort of patients with central nervous system metastases from thyroid cancer

H&uuml;rthle cell carcinoma: current perspectives

The Largest Known Survival Analysis of Patients With Brain Metastasis From Thyroid Cancer Based on Prognostic Groups

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Hürthle cell carcinoma: current perspectives