The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2004 March;48(1):12-9

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Lung metastases from differentiated thyroid carcinoma. A 40 years’ experience

Ronga G. ¹, Filesi M. ¹, Montesano T. ¹, Di Nicola A. D. ¹, Pace C. ¹, Travascio L. ¹, Ventroni G. ¹, Antonaci A. ², Vestri A. R. ³

¹ Unit of Nuclear Medicine, Department of Clinical Sciences “Umberto I Polyclinic”,“La Sapienza” University, Rome, Italy 2 Surgical Science and Applied Medical Technologies Department “Umberto I Polyclinic”, “La Sapienza” University, Rome, Italy 3 Experimental Department “Umberto I Polyclinic”, “La Sapienza” University, Rome, Italy

Aim. Retrospective stud­ies ­have ­been car­ried out to esti­mate the sur­vi­val of 96 ­patients ­with ­lung metas­ta­ses ­from dif­fer­en­tiat­ed thy­roid car­ci­no­ma, ­observed ­from 1958 to 2000.
Methods. All ­patients had under­gone ­total thy­roi­dec­to­my. Case his­to­ries ­were ana­lysed ­with ­respect to age at diag­no­sis, sex, his­tol­o­gy, ­local ­lymph ­node involve­ment, ­size of ­lung metas­ta­ses and 131I ­uptake by metas­ta­ses. Survival func­tions ­were cal­cu­lat­ed. Cox regres­sion was per­formed.
Results. There was no sta­tis­ti­cal­ly sig­nif­i­cant dif­fer­ence in his­to­log­i­cal ­type and ­lymph ­node involve­ment, where­as a sig­nif­i­cant­ly long­er sur­vi­val ­time was ­observed in ­patients ­under 45 ­years of age at diag­no­sis (p≤0.0001), in ­those ­with metas­ta­ses con­cen­trat­ing 131I (p≤0.0001) and in ­those ­with ­fine mil­i­ar­ic metas­ta­ses (p=0.0037). Multi-variate anal­y­sis ­revealed ­that the ­risk of ­death increas­es ­about 5.4-­fold in ­patients ­over 45 ­years old, where­as 131I treat­ment is like­ly to ­reduce ­this ­risk to near­ly 1/6.
Conclusion. In con­clu­sion, in ­patients ­with ­lung metas­ta­ses ­from dif­fer­en­tiat­ed thy­roid car­ci­no­ma, ­young age at diag­no­sis and 131I ­uptake by metas­ta­ses are the ­most impor­tant fac­tors pos­i­tive­ly affect­ing sur­vi­val ­time. Radioiodine ther­a­py, ­also ­with ­high cumu­la­tive 131I activ­ity, can ­lead to long­er sur­vi­val ­time or com­plete recov­ery.