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Clinical outcomes and prognostic factors in patients with no less than three distant organ system metastases from differentiated thyroid carcinoma

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Abstract

Objectives

For patients with differentiated thyroid carcinoma (DTC), distant metastases are commonly identified in the lungs and bones. However, they are relatively rare in other distant organs, such as the liver, kidneys, or brain. The aim of the current study was to describe the clinical outcomes and evaluate the prognostic factors of patients with no less than three different distant organ system metastases from DTC.

Methods

This study retrospectively identified 717 patients diagnosed with DTC with distant metastases between January 2005 and December 2017. Patient response to radioactive iodine (RAI) therapy was monitored by changes in serum thyroglobulin levels and imaging changes. Five-year and 10-year overall survival (OS) rates were calculated by the Kaplan–Meier methods and Cox proportional hazards.

Results

Among the 717 participants, 37 (5.16%) patients had no less than three different distant organ system metastases from DTC. Five-year and 10-year OS were 45.9% and 37.8% in patients with three or more distant organ system metastases while 74.5% and 64.9% in individuals with one or two distant organ system metastases, respectively. RAI avidity and RAIR-DTC were main independent prognostic factors influencing the clinical outcomes for both groups of patients. The presence of 3 or more different distant organ system metastases was the only independent prognostic factors for 10-year OS by multivariate analysis.

Conclusions

Patients with no less than three distant organ system metastases from DTC had poor prognosis. RAI avidity and RAIR-DTC were main factors influencing overall survival for patients with distant metastases from DTC in both groups.

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Acknowledgements

The authors thank the American Journal Experts for their help with the edition for proper English language, grammar, punctuation, spelling, and overall style by one or more of the highly qualified native English-speaking editors for this paper. This study was supported by the National Natural Science Foundation of China (Grant number 81671712) and the Shanghai Key Discipline of Medical Imaging (Grant number 2017ZZ02005).

Author contributions

X.Y.Z. and Z.L.Q. designed the study. X.Y.C. and J.W.S. conducted the statistical analysis. Y.W. collected the clinical data. X.Y.Z. wrote the whole paper. J.H.Z. and Q.Y.L. supervised and edited the paper. All authors read and approved the final paper.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China

    Xin-Yun Zhang, Jian-Wen Sun, Zhong-Ling Qiu, Yang Wang, Xiao-Yue Chen & Quan-Yong Luo

  2. Department of Nuclear Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Xin-Yun Zhang & Jin-Hua Zhao

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Zhang, XY., Sun, JW., Qiu, ZL. et al. Clinical outcomes and prognostic factors in patients with no less than three distant organ system metastases from differentiated thyroid carcinoma. Endocrine 66, 254–265 (2019). https://doi.org/10.1007/s12020-019-01999-6

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