Pleural metastases from differentiated thyroid cancer: clinical features and long-term outcomes.

IF 3.5 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

European Thyroid Journal Pub Date : 2025-01-29 Print Date: 2025-02-01 DOI:10.1530/ETJ-24-0147

Mengyue Liu, Juan Tang, Nan Sun, Chuang Xi, Chentian Shen, Song Hongjun, Quanyong Luo, Xianzhao Deng, Zhongling Qiu

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引用次数: 0

Abstract

Objective: Pleural metastasis (PM) is rare in patients with differentiated thyroid cancer (DTC). Radioiodine (131I) therapy has been the main treatment for postoperative metastasis and recurrence of DTC. However, clinical data on PM from DTC are limited. This study investigated the clinicopathological characteristics of patients with PM from DTC that were treated surgically and with 131I therapy and evaluated their long-term prognosis and prognostic factors.

Methods: A review of the Shanghai Sixth People's Hospital medical records from 2010 to 2023 identified PM in 27 of 14,473 patients with DTC. Overall survival (OS) was assessed by the Kaplan-Meier method.

Results: The prevalence of PM in DTC was 1.87‰ (27/14,473). The median age at the time of initial diagnosis of PM was 59 years (range: 34-79). At the end of follow-up, eight patients (29.63%) had disease progression (PD), four (14.81%) had a partial response, and the remainder had stable disease; no patient achieved complete response. Twelve patients (44.44%) died, and 15 (55.56%) survived. Thirteen patients (48.15%) did not show 131I avidity, and 16 (59.26%) had radioiodine-refractory DTC (RR-DTC). Twenty patients (74.07%) had malignant pleural effusion (MPE), which was large in 11 cases (40.74%) and moderate in two. More-than-moderate MPE (P = 0.031), lack of 131I avidity (P = 0.041) and RR-DTC (P = 0.030) were significantly associated with worse 5-year OS in patients with PM of DTC.

Conclusions: PM is rare in DTC. Lack of 131I avidity, RR-DTC and more-than-moderate MPE are associated with poor OS in patients with DTC and PM.

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分化型甲状腺癌的胸膜转移：临床特征和长期预后。

目的：胸膜转移（PM）在分化型甲状腺癌（DTC）中较为少见。放射性碘（131I）治疗是DTC术后转移和复发的主要治疗方法。然而，来自DTC的PM临床数据有限。本研究探讨手术和131I治疗的DTC PM患者的临床病理特征，并评估其长期预后和预后因素。方法：回顾上海市第六人民医院2010-2023年的病历，在14473例DTC患者中发现27例PM。采用Kaplan-Meier法评估总生存期（OS）。结果：DTC中PM的患病率为1.87‰（27/ 14473）。初次诊断PM时的中位年龄为59岁（范围34-79岁）。随访结束时，8例患者（29.63%）出现疾病进展（PD）， 4例患者（14.81%）出现部分缓解（PR），其余患者病情稳定（SD）；没有患者达到完全缓解（CR）。死亡12例（44.44%），存活15例（55.56%）。13例（48.15%）患者未出现131 - i亲切度，16例（59.26%）患者存在放射性碘难治性DTC （RR-DTC）。恶性胸腔积液（MPE） 20例（74.07%），其中重度11例（40.74%），中度2例。中度以上MPE （P=0.031）、缺乏131I亲切度（P=0.041）和RR-DTC （P=0.030）与DTC PM患者的5年OS恶化显著相关。结论：PM在DTC中罕见。缺乏131I贪婪度、RR-DTC和中度以上MPE与DTC和PM患者的不良OS相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.