Long-term outcomes and prognostic factors in papillary thyroid microcarcinoma patients with distant metastases

Purposes Distant metastasis from papillary thyroid microcarcinoma (PTMC) is extremely rare and the long-term outcomes and independent prognostic factors remain unclear. The present study aimed to investigate clinicopathological characteristics and evaluate the long-term outcomes and prognostic facto...

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Published in:Endocrine 2022-02, Vol.75 (2), p.495-507
Main Authors: Weng, Huai-Yu, Yan, Ting, Qiu, Wang-Wang, Xi, Chuang, Hou, Li-Ying, Yang, Zhi-Li, Qiu, Zhong-Ling
Format: Article
Language:English
Subjects:
Carcinoma, Papillary
Cohort Studies
Diabetes
Endocrinology
Humanities and Social Sciences
Humans
Internal Medicine
Iodine
Iodine Radioisotopes - therapeutic use
Male
Medical prognosis
Medical records
Medicine
Medicine & Public Health
Metastases
Metastasis
multidisciplinary
Multivariate analysis
Original Article
Patients
Prognosis
Retrospective Studies
Science
Survival
Thyroid cancer
Thyroid gland
Thyroid Neoplasms - pathology
Thyroidectomy
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Summary:Purposes Distant metastasis from papillary thyroid microcarcinoma (PTMC) is extremely rare and the long-term outcomes and independent prognostic factors remain unclear. The present study aimed to investigate clinicopathological characteristics and evaluate the long-term outcomes and prognostic factors of PTMC patients with distant metastases (DM) who underwent surgery and radioactive iodine ( 131 I) treatment. Methods We retrospectively reviewed the medical records of 13,441 patients with thyroid cancer (including 1697 cases with PTMC) who underwent 131 I treatment at our institution between January 2008 and December 2019. PTMC patients with distant metastases with sufficient clinical follow-up data were enrolled in this cohort study. The overall survival (OS) and progression-free survival (PFS) were analyzed by the Kaplan–Meier method and the prognostic factors were assessed by Cox proportional hazards. Results Thirty-three PTMC patients with DM were enrolled in this study. The median follow-up was 75 months (range: 5–151 months). The 5-year and 10-year OS rates were 96.97 and 81.41%, respectively, and the 5-year and 10-year PFS rates were 90.46 and 69.68%, respectively. Multivariate analysis showed that male sex ( P  = 0.005), radioactive iodine refractory PTMC ( P  = 0.033), and symptomatic DM ( P  = 0.022) were significantly associated with worse 10-year PFS in PTMC patients with DM. No independent predictor related to poor 10-year OS was found in the present study. Conclusions The prognosis of PTMC patients becomes worse after the development of DM. Male sex, radioactive iodine refractory PTMC, and symptomatic DM were identified as independent factors associated with PFS.
ISSN:1355-008X
1559-0100
DOI:10.1007/s12020-021-02906-8