Follicular thyroid carcinoma with distant metastasis: outcome and prognostic factor

Kiminori Sugino; Kaori Kameyama; Mitsuji Nagahama; Wataru Kitagawa; Hiroshi Shibuya; Keiko Ohkuwa; Takashi Uruno; Junko Akaishi; Akifumi Suzuki; Chie Masaki; Kenichi Matsuzu; Michikazu Kawano; Koichi Ito

doi:10.1507/endocrj.EJ13-0437

ORIGINALS

Follicular thyroid carcinoma with distant metastasis: outcome and prognostic factor

Kiminori Sugino, Kaori Kameyama, Mitsuji Nagahama, Wataru Kitagawa, Hiroshi Shibuya, Keiko Ohkuwa, Takashi Uruno, Junko Akaishi, Akifumi Suzuki, Chie Masaki, Kenichi Matsuzu, Michikazu Kawano, Koichi Ito

Author information

Kiminori Sugino
Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan
Kaori Kameyama
Division of Diagnostic Pathology, Keio University Hospital, Tokyo 160-8582, Japan
Mitsuji Nagahama
Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan
Wataru Kitagawa
Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan
Hiroshi Shibuya
Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan
Keiko Ohkuwa
Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan
Takashi Uruno
Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan
Junko Akaishi
Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan
Akifumi Suzuki
Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan
Chie Masaki
Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan
Kenichi Matsuzu
Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan
Michikazu Kawano
Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan
Koichi Ito
Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan

Keywords: Follicular thyroid carcinoma, Distant metastasis, Radioactive iodine therapy, Prognostic factor

JOURNAL FREE ACCESS

2014 Volume 61 Issue 3 Pages 273-279

DOI https://doi.org/10.1507/endocrj.EJ13-0437

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Abstract

Follicular thyroid carcinoma (FTC) usually has a good prognosis unless there is distant metastasis (DM). In this retrospective study we evaluated the outcome of FTC patients with DM and attempted to identify prognostic factors. The subjects of this study were the 106 of FTC patients who underwent thyroidectomy at our hospital between 1989 and 2010 who had been diagnosed with DM at presentation or had developed DM after the initial surgery. Their cumulative cause-specific survival (CSS) rate from diagnosis of DM to date of last follow-up was calculated by the Kaplan-Meier method. Prognostic factors were identified by univariate analysis (the log-rank test) and multivariate analysis (Cox’s proportional hazards model). The site of the DM was the lung in 36 patients, bone in 33 patients, both lung and bone in 28 patients and other sites in 9 patients. During the follow-up period, 22 patients died of their disease. The DMs were treated by radioactive iodine (RI) therapy in 80 patients, by surgical treatment in 36 patients and by external beam radiation therapy (EBRT) in 27 patients. The CSS rates at 5, 10, and 15 years after the first DM was diagnosed were 82.2%, 63.8%, and 23.9%, respectively. Univariate analyses and multivariate analysis identified age at diagnosis of DM and primary tumor size as significant factors related to CSS. In this study, we could not show RI therapy, EBRT or surgical treatment for DM had an impact on the outcome.

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