Thyroid Carcinoma with Bone Metastases: A Prognostic Factor Study

Abstract

Objective: Occult clinical presentations usually hinder the early detection and management of patients with bone metastases from thyroid carcinoma. We retrospectively investigated the clinical outcomes of such patients from 1993 to 2004 and analyzed the prognostic parameters. Design:The basic demographic data and manifestations of 44 patients who had thyroid carcinoma with bone metastases were reviewed. We studied the gender, age, locations of metastases, histological types, treatment methods, hypercalcemic episodes and results of treatments. We used Kaplan-Meier survival analysis and log-rank tests to access the statistical signifi cance. Main outcome:The incidence of bone metastasis from thyroid carcinomas in this series was 5.0%. Twenty patients (45.4%) had follicular, 16 (36.3%) had papillary, 3 (6.8%) had anaplastic, 3 (6.8%) had medullary, and 2 (4.5%) had Hurthel cell carcinomas. Twelve patients had hypercalcemic episodes, ranging from 2.6 to 2.9 mmolL −1 (mean ± SD: 2.68 ± 0.15 mmolL). Survival time after bone metastases ranged from 2 months to 8 years (mean ± SD: 5.3 ± 1.3 years). The 5-year survival rate was 79.4% and the 10-year survival rate was 52.9%. Regarding the histological cancer type, patients with papillary and follicular cancers survived signifi cantly longer than those with anaplastic and medullary cancers (p Ͻ 0.05). In addition, the patients presenting with hypercalcemia had the worst survival (p Ͻ 0.05). Conclusions:Thyroid carcinoma can present with bone metastases in its early stage. We found that both tumor type and hypercalcemia were signifi cant prognostic factors for survival time.

Elevated level of serum carbohydrate antigen 19.9 as predictor of mortality in patients with advanced medullary thyroid cancer

“…The only statistical difference between the two groups was that distant metastases, particularly bone and liver metastases, which are known to be a poor prognostic factor for survival (7,8,9,29), were much more frequent in patients with elevated levels of Ca 19.9 at the time of observation. However, in the present selected series, the distant metastases did not correlate with death while it did occur for Ca 19.9, suggesting a stronger prognostic role of this serum marker in this subset of advanced cases.…”

Management of differentiated thyroid carcinoma with bone metastasis: a case report and review of the Chinese literature

“…Wu et al (2008), who analyzed 44 patients of thyroid carcinoma with bone metastasis, showed that proper operations aiming at preventing or treating complications of metastatic bone disease appear to be useful in improving morbidity in patients with skeletal disease. Bernier et al (2001) retrospectively studied 109 DTC with bone metastasis, in which 24 (22%) patients were treated by complete excision of the metastasis, 60 (55%) patients were treated by partial removal, while others did not receive any surgery, with the median survival time being 6.2, 4.2, and 2.5 years, respectively (P<0.05).…”

Rare Late Mandibular Metastasis in Follicular Variant of Papillary Carcinoma Thyroid: ‘Resurgence of the Sleeping Tumour’

“…Despite the relatively indolent behavior of encapsulated follicular thyroid neoplasm, the 5-year survival rate in patients detected with bony metastases in invasive FVPTC is reported to be 79.4% with 10-year survival rate being 52.9% [47].…”