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Article: Evaluating the prognostic factors associated with cancer-specific survival of differentiated thyroid carcinoma presenting with distant metastasis

TitleEvaluating the prognostic factors associated with cancer-specific survival of differentiated thyroid carcinoma presenting with distant metastasis
Authors
Issue Date2013
PublisherSpringer New York LLC. The Journal's web site is located at http://www.annalssurgicaloncology.org
Citation
Annals of Surgical Oncology, 2013, v. 20 n. 4, p. 1329-1335 How to Cite?
AbstractBACKGROUND: Because patients with differentiated thyroid carcinoma (DTC) presenting with distant metastasis (DM) have a particularly poor prognosis, examining the prognostic factors in this group is essential. We aimed to evaluate the prognostic factors affecting cancer-specific survival (CSS) in DTC patients presenting with DM. METHODS: Of the 1227 DTC patients, 51 (4.2 %) presented with DM at diagnosis. All patients underwent a total thyroidectomy, followed by radioiodine (RAI) ablation and postablation whole body scan (WBS). Patients were considered to have an osseous metastasis if one of the metastatic sites involved a bone, while RAI avidity was determined by any visual uptake in a known metastatic site on the first WBS. Factors predictive of CSS were determined by univariate and multivariate analyses by the Cox proportional hazard model. RESULTS: In univariate analysis, older age (relative risk [RR] 1.050, 95 % confidence interval [CI] 1.010-1.091, P = 0.014), DM discovered before WBS (RR 3.401, 95 % CI 1.127-10.309, P = 0.030), follicular thyroid carcinoma (RR 3.095, 95 % CI 1.168-8.205, P = 0.025), osseous metastasis (RR 4.695, 95 % CI 1.379-15.873, P = 0.013), non-RAI avidity (RR 3.355, 95 % CI 1.280-8.772, P = 0.014), and external beam radiotherapy to DM (RR 3.241, 95 % CI 1.093-9.614, P = 0.034) were significant poor prognostic factors for CSS. In the multivariate analysis, after adjusting for other factors, osseous metastasis (RR 6.849, 95 % CI 1.495-31.250, P = 0.013) and non-RAI avidity (RR 7.752, 95 % CI 2.198-27.027, P = 0.001) were the two independent poor prognostic factors for CSS. Older age almost reached statistically significance (RR 1.055, 95 % CI 0.996-1.117, P = 0.068). CONCLUSIONS: DTC patients presenting with DM accounted for 4.2 % of all patients. Because osseous metastasis and RAI avidity were independent prognostic factors, future therapy should be directed at improving the treatment efficacy of osseous and/or non-RAI-avid metastases.
Persistent Identifierhttp://hdl.handle.net/10722/174150
ISSN
2015 Impact Factor: 3.655
2015 SCImago Journal Rankings: 1.902
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLang, BHHen_US
dc.contributor.authorWong, KPen_US
dc.contributor.authorCheung, CYen_US
dc.contributor.authorWan, KYen_US
dc.contributor.authorLo, CYen_US
dc.date.accessioned2012-11-16T03:37:04Z-
dc.date.available2012-11-16T03:37:04Z-
dc.date.issued2013en_US
dc.identifier.citationAnnals of Surgical Oncology, 2013, v. 20 n. 4, p. 1329-1335en_US
dc.identifier.issn1068-9265-
dc.identifier.urihttp://hdl.handle.net/10722/174150-
dc.description.abstractBACKGROUND: Because patients with differentiated thyroid carcinoma (DTC) presenting with distant metastasis (DM) have a particularly poor prognosis, examining the prognostic factors in this group is essential. We aimed to evaluate the prognostic factors affecting cancer-specific survival (CSS) in DTC patients presenting with DM. METHODS: Of the 1227 DTC patients, 51 (4.2 %) presented with DM at diagnosis. All patients underwent a total thyroidectomy, followed by radioiodine (RAI) ablation and postablation whole body scan (WBS). Patients were considered to have an osseous metastasis if one of the metastatic sites involved a bone, while RAI avidity was determined by any visual uptake in a known metastatic site on the first WBS. Factors predictive of CSS were determined by univariate and multivariate analyses by the Cox proportional hazard model. RESULTS: In univariate analysis, older age (relative risk [RR] 1.050, 95 % confidence interval [CI] 1.010-1.091, P = 0.014), DM discovered before WBS (RR 3.401, 95 % CI 1.127-10.309, P = 0.030), follicular thyroid carcinoma (RR 3.095, 95 % CI 1.168-8.205, P = 0.025), osseous metastasis (RR 4.695, 95 % CI 1.379-15.873, P = 0.013), non-RAI avidity (RR 3.355, 95 % CI 1.280-8.772, P = 0.014), and external beam radiotherapy to DM (RR 3.241, 95 % CI 1.093-9.614, P = 0.034) were significant poor prognostic factors for CSS. In the multivariate analysis, after adjusting for other factors, osseous metastasis (RR 6.849, 95 % CI 1.495-31.250, P = 0.013) and non-RAI avidity (RR 7.752, 95 % CI 2.198-27.027, P = 0.001) were the two independent poor prognostic factors for CSS. Older age almost reached statistically significance (RR 1.055, 95 % CI 0.996-1.117, P = 0.068). CONCLUSIONS: DTC patients presenting with DM accounted for 4.2 % of all patients. Because osseous metastasis and RAI avidity were independent prognostic factors, future therapy should be directed at improving the treatment efficacy of osseous and/or non-RAI-avid metastases.-
dc.languageengen_US
dc.publisherSpringer New York LLC. The Journal's web site is located at http://www.annalssurgicaloncology.org-
dc.relation.ispartofAnnals of Surgical Oncologyen_US
dc.rightsThe original publication is available at www.springerlink.com-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleEvaluating the prognostic factors associated with cancer-specific survival of differentiated thyroid carcinoma presenting with distant metastasisen_US
dc.typeArticleen_US
dc.identifier.emailLang, BHH: blang@hku.hken_US
dc.identifier.emailLo, CY: cylo@hkucc.hku.hken_US
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1245/s10434-012-2711-x-
dc.identifier.pmid23104708-
dc.identifier.scopuseid_2-s2.0-84875149129-
dc.identifier.hkuros212309en_US
dc.identifier.isiWOS:000316392600040-
dc.publisher.placeUnited States-
dc.identifier.citeulike11607991-

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