Treatment and prognosis for patients with differentiated thyroid carcinoma bone metastases

Shiqi Wang, Juanzhang Luo, Zhaoming Zhong, Xiao Qi, Ting Liu, Rujia Qin, Zaili Zhao, Yan Xi, Ruimei Sun, Yaohong Wu, Chuanzheng Sun

Abstract

Background: To investigate reasonable treatment modalities and prognostic factors for patients with differentiated thyroid carcinoma (DTC) bone metastases (BM).
Methods: The clinicopathological characteristics and follow-up data for all patients with DTC BM who received treatment in the Third Affiliated Hospital of Kunming Medical University between November 1, 1993 and December 31, 2016 were analyzed retrospectively with respect to mortality and survival rates. Multivariate analysis was performed using the Cox proportional hazard model.
Results: The 5- and 10-year overall survival (OS) rates were 51.5% and 17.2%, respectively, for all 60 patients. Univariate analysis showed that patients diagnosed with BM at <45 years of age, with controlled thyroid-stimulating hormone (TSH) levels and those undergoing surgery or 131I therapy had better prognoses. Patients with cervical vertebra metastases, multiple organ metastases other than bone, and those receiving chemotherapy had worse prognoses. Gender, pathological type, number of BM lesions, skeletal- related events (SREs) and whether or not the patient received radiotherapy were not related to prognosis. Cox regression analysis showed that age at diagnosis of BM, undergoing surgery for bone lesions, and not receiving chemotherapy were independent factors of favorable prognosis for patients with DTC BM.
Conclusions: Patients with DTC BM have poor prognoses. Age at diagnosis with BM <45 years old, undergoing surgery for bone lesions, and not receiving chemotherapy were independent factors of favorable prognosis for patients with DTC BM. 131I combined with surgery for bone metastatic lesions may be the best treatment model for most patients with DTC BM disease.