Bone metastases from differentiated thyroid cancer: characteristics and prognostic factors in a multicenter series.

IF 3.5 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

European Thyroid Journal Pub Date : 2023-08-23 Print Date: 2023-10-01 DOI:10.1530/ETJ-23-0086

Ana Piñar-Gutiérrez, Ana R Romero-Lluch, Suset Dueñas-Disotuar, Irene de Lara-Rodríguez, Mª Ángeles Gálvez-Moreno, Tomás Martín-Hernández, Jorge García-Alemán, Guillermo Martínez-de Pinillos, Elena Navarro-González

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引用次数: 0

Abstract

Objective: The aim of this study is to describe the characteristics, survival and prognostic factors of a cohort of patients with bone metastases (BMs) from differentiated thyroid carcinoma (DTC).

Methods: This was a multicenter retrospective observational study including patients diagnosed with BMs from DTC between 1980 and 2021. A Cox regression was performed to study prognostic factors for 5- and 10-year survival. Kaplan-Meier and log-rank tests were performed for the survival analysis and comparison between groups.

Results: Sixty-three patients were evaluated. Median follow-up from BM diagnosis was 35 (15-68) months. About 30 (48.4%) patients presented with synchronous BMs. Regarding histology, 38 (60.3%) had the papillary variant. BMs were multiple in 32 (50.8%) patients. The most frequent location was the spine (60.3%). Other metastases were present in 77.8%, mainly pulmonary (69.8%). Concerning treatment, 54 (85.9%) patients received I131, with BM uptake in 31 (49.2%) and 25 (39.7%) received treatment with multikinase inhibitors. Regarding complications, 34 (54%) patients had skeletal-related events, 34 (54%) died and 5- and 10-year overall survival was 42.4% and 20.4%, respectively. Significant prognostic factors in the multivariate analysis were the presence of lymph node involvement (hazard ratio (HR): 2.916; 95% confidence interval (CI): 1.013-8.391; P = 0.047) and treatment with I131 (HR 0.214 (95% CI 0.069-0.665); P = 0.008) at 5 years, the presence of other metastases (HR 6.844. 95% CI 1.017-46.05; P = 0.048) and treatment with I131 (HR 0.23 (95% CI 0.058-0.913); P = 0.037) at 10 years.

Conclusions: Our study reflects the management of patients with bone metastases from differentiated thyroid carcinoma in real clinical practice in several centers in southern Spain. Overall survival at 5 and 10 years was lower in patients who were not treated with I131, had nodal involvement and/or had other metastases.

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分化型甲状腺癌症骨转移：多中心系列的特征和预后因素。

目的：本研究的目的是描述一组分化型甲状腺癌骨转移患者的特征、生存率和预后因素。方法：这是一项多中心回顾性观察性研究，包括1980年至2021年间诊断为DTC BMs的患者。采用Cox回归研究5年和10年生存期的预后因素。Kaplan-Meier和log秩检验用于生存分析和组间比较。结果：63名患者接受了评估。BM诊断的中位随访时间为35（15-68）个月。约有30名（48.4%）患者出现同步骨髓瘤。在组织学方面，38例（60.3%）有乳头状变异。32例（50.8%）患者出现多发性骨髓瘤。最常见的部位是脊柱（60.3%）。其他转移灶存在于77.8%，主要是肺部（69.8%）。在治疗方面，54名（85.9%）患者接受了I131治疗，31名（49.2%）患者接受BM摄取，25名（39.7%）患者接受多激酶抑制剂治疗。在并发症方面，34名（54%）患者发生骨骼相关事件，34人（54%）死亡，5年和10年总生存率分别为42.4%和20.4%。多变量分析中的重要预后因素是淋巴结受累的存在（危险比（HR）：2.916；95%置信区间（CI）：1.013-8.391；P=0.047）和I131处理（HR 0.214（95%CI 0.069-0.665）；P=0.008）、存在其他转移（HR6.844。95%置信区间1.017-46.05；P=0.048）和I131治疗（HR 0.23（95%CI 0.058-0.913）；P=0.037）。结论：我们的研究反映了西班牙南部几个中心在实际临床实践中对分化型甲状腺癌骨转移患者的管理。未接受I131治疗、有淋巴结受累和/或有其他转移的患者在5年和10年时的总生存率较低。

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来源期刊

European Thyroid Journal Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.70

自引率

2.10%

发文量

156

期刊介绍： The ''European Thyroid Journal'' publishes papers reporting original research in basic, translational and clinical thyroidology. Original contributions cover all aspects of the field, from molecular and cellular biology to immunology and biochemistry, from physiology to pathology, and from pediatric to adult thyroid diseases with a special focus on thyroid cancer. Readers also benefit from reviews by noted experts, which highlight especially active areas of current research. The journal will further publish formal guidelines in the field, produced and endorsed by the European Thyroid Association.