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Prognostic significance of lung metastasis-related finding in lenvatinib treatment for differentiated thyroid cancer

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Abstract

Purpose

This study aimed to analyze the clinical course of patients with differentiated thyroid cancer (DTC) who were treated by lenvatinib and investigate the specific criteria for the initiation of lenvatinib in lung metastasis.

Methods

A total of 111 patients with DTC treated by lenvatinib were included in the study. Patients were divided into two groups based on the target lesion for the initiation of lenvatinib: lung metastasis group and other metastases group.

Results

In the univariate analysis, the tumor size for the lung metastasis (p = 0.002) and the factor of lung metastasis group (p < 0.001) were significantly associated with overall survival (OS). Multivariate analysis revealed that the factor of lung metastasis group [hazard ratio, 0.408; 95% confidence interval (CI), 0.206–0.810; p = 0.010] was the only independent prognostic factor of OS. Of the 53 patients in the lung metastasis group, 12 (23%) had lung metastasis-related finding such as pleural effusion (n = 12), hemoptysis (n = 2), and dyspnea (n = 1) at the initiation of lenvatinib treatment. The median OS in patients with or without lung metastasis-related findings were 41.0 [95% CI, 10.4–not available (NA)] months and 62.9 (95% CI, 53.0–NA) months, respectively (p = 0.022).

Conclusion

Patients with lung metastasis-related finding at the initiation of lenvatinib treatment had a poorer prognosis among the lung metastasis group. It is important to consider not only the tumor size but also the presence of lung metastasis-related findings when initiating lenvatinib treatment for DTC patients with lung metastasis.

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Acknowledgements

We thank Enago (https://www.enago.jp/) for editing this manuscript.

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Authors and Affiliations

  1. Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan

    Haruhiko Yamazaki & Katsuhiko Masudo

  2. Department of Breast and Endocrine Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan

    Haruhiko Yamazaki, Hiroyuki Iwasaki, Soji Toda & Ai Matsui

  3. Department of Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan

    Yasushi Rino

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  1. Haruhiko Yamazaki
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Correspondence to Haruhiko Yamazaki.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board of Kanagawa Cancer Center (IRB approval no. 2022-4) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Yamazaki, H., Iwasaki, H., Masudo, K. et al. Prognostic significance of lung metastasis-related finding in lenvatinib treatment for differentiated thyroid cancer. Endocrine 78, 543–551 (2022). https://doi.org/10.1007/s12020-022-03183-9

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  • DOI: https://doi.org/10.1007/s12020-022-03183-9

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