Patterns of metastasis in follicular thyroid carcinoma and the difference between early and delayed presentation

Patterns of metastasis in follicular thyroid carcinoma and the difference between early and delayed presentation

Introduction Follicular thyroid cancer (FTC) has a good prognosis if treated early. The aim of this study was to look at the difference in outcomes in those who presented with metastasis early or late in their disease. Methods A retrospective cohort study was conducted of patients diagnosed with FTC...

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Bibliographic Details
Published in:Annals of the Royal College of Surgeons of England Vol. 99; no. 2; pp. 151 - 154
Main Authors: Parameswaran, R, Shulin Hu, J, Min En, N, Tan, W B, Yuan, N K
Format: Journal Article
Language:English
Published: England BMJ Publishing Group LTD 01-02-2017
Royal College of Surgeons
Subjects:
Adenocarcinoma, Follicular - mortality
Adenocarcinoma, Follicular - pathology
Adenocarcinoma, Follicular - radiotherapy
Adenocarcinoma, Follicular - surgery
Adolescent
Adult
Aged
Aged, 80 and over
Bones
Female
Histology
Humans
Iodine
Kaplan-Meier Estimate
Leukemia
Lungs
Lymphatic system
Male
Medical prognosis
Metastasis
Middle Aged
Multivariate analysis
Orthopaedic Surgery
Patients
Radiation therapy
Retrospective Studies
Standard deviation
Surgery
Surveillance
Thyroid cancer
Thyroid Neoplasms - mortality
Thyroid Neoplasms - pathology
Thyroid Neoplasms - radiotherapy
Thyroid Neoplasms - surgery
Thyroidectomy
Young Adult
Radioiodine
Follicular
Radiotherapy
Thyroidectomy
Cancer
Thyroid
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Summary:Introduction Follicular thyroid cancer (FTC) has a good prognosis if treated early. The aim of this study was to look at the difference in outcomes in those who presented with metastasis early or late in their disease. Methods A retrospective cohort study was conducted of patients diagnosed with FTC (n=91) treated between 2000 and 2013. Demographic, laboratory, pathological and survival data were collected and analysed. Results Metastatic FTC was diagnosed in 20 cases (22%). The median age at diagnosis was 65 years (range: 17-86 years) and 65% of the patients were female. Twelve patients (60%) were diagnosed with metastatic disease at presentation, with the bones being the most common site (75%). In the remaining eight cases (40%), metastasis developed at a median of 4.5 years (range: 2-8 years) after initial thyroid surgery, lungs being the most common site (50%). Eighteen patients (90%) underwent surgical intervention for the primary disease. Sixteen patients (80%) received adjuvant radioactive iodine and eight (40%) received external beam radiotherapy. Widely invasive follicular cancer was the predominant histological diagnosis (90%). No prognostic association was observed with any of the parameters studied. The overall disease specific mortality rate was 40%. There was no significant difference in mortality between those who presented with metastatic disease and those who developed metastasis during the follow-up period (33% vs 50%, p=0.61). Conclusions The clinical outcome and prognosis for cases with metastatic disease is generally poor. Despite this, almost half of the patients in our study were still alive at a median follow-up of 5.5 years, regardless of whether they were diagnosed with metastatic disease on initial presentation or whether they developed metastasis after initial thyroid surgery.
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ISSN:0035-8843
1478-7083
DOI:10.1308/rcsann.2016.0300