Differentiated thyroid cancer presenting with distant metastases: a population analysis over two decades

Area of Science:

• Oncology
• Endocrinology
• Cancer Epidemiology

Background:

• Differentiated thyroid cancer (DTC) with distant metastases at presentation is uncommon.
• The prognosis for patients with DTC and distant metastases is generally more favorable than for other advanced cancers.
• Understanding demographic, clinical, and pathological factors is crucial for identifying survival predictors.

Purpose of the Study:

• To describe the demographic, clinical, and pathological characteristics of differentiated thyroid cancer patients with distant metastases at presentation.
• To identify factors associated with long-term disease-specific survival in patients with DTC and distant metastases.
• To analyze trends in survival for met-DTC over two decades.

Main Methods:

• Utilized the Surveillance, Epidemiology, and End Results (SEER) database from 1988-2009.
• Categorized patients into groups with distant metastases (met-DTC) and without (DTC) at presentation.
• Employed chi-square tests, ANOVA, Kaplan-Meier analysis, and regression models for data analysis.

Main Results:

• 1,291 met-DTC patients and 58,518 DTC patients were analyzed; met-DTC rate was 2.2%.
• Met-DTC patients were more likely to be male, older, have larger tumors, and less likely to have had surgery or received radioactive iodine (RAI).
• Independent predictors of mortality included age ≥ 45, single status, specific histologies, larger tumors, and lack of surgery/RAI. Survival has not improved over two decades.

Conclusions:

• Differentiated thyroid cancer with distant metastases remains an uncommon diagnosis.
• The lack of survival improvement over the past 20 years highlights the need for novel therapeutic strategies.
• Aggressive pursuit of new treatments is essential for improving outcomes in met-DTC patients.