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Published on: February 3, 2023
Brain Metastases From Differentiated Thyroid Carcinoma: A Retrospective Study of 22 Patients
Tong Wu1, Zan Jiao1, Yixuan Li1
1Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.
Background:
Brain metastasis from differentiated thyroid cancer has followed a similar increasing trend to that of thyroid cancer in recent years. However, the characteristics and treatments for brain metastases are unclear. The aim of this study was to understand this disease by analyzing patients with brain metastases from differentiated thyroid cancer (DTC).
Methods:
Between 2000 and 2020, the database of the Sun Yat-sen University Cancer Center was searched for differentiated thyroid cancer patients. We identified a cohort of 22 patients with brain metastases. The characteristics of the patients, histological features, treatments, and time of death were reviewed. The overall survival (OS) rate was calculated using the Kaplan Meier method. Survival curves of different subgroups were compared according to baseline characteristics and treatments received.
Results:
A total of 22 (1.09%) out of 2013 DTC patients in the Sun Yat-sen University Cancer Center database were identified as having brain metastases. The overall median survival time was 17.5 months (range from 1-60 months) after diagnosis of brain metastasis. Performance statue (PS), tumor site, and neurosurgery impacted survival, according to Kaplan-Meier analysis. Prognosis of skull metastasis was superior to that of intracranial types. Neurosurgery was the only type of treatment that had an impact on patient OS.
Conclusions:
Brain metastasis from differentiated thyroid cancer has a poor prognosis. However, it can be improved by comprehensive treatment. PS of the patients can greatly affect survival. Skull metastases have improved prognosis over intracranial types. Radioiodine therapy (RAIT) appears to effectively improve the prognosis of patients with skull metastases from DTC.
Insights
Brain metastases from differentiated thyroid cancer (DTC) are increasing. While prognosis is poor, neurosurgery and radioiodine therapy (RAIT) can improve survival, especially for skull metastases.
Area of Science:
- Oncology
- Neurosurgery
- Radiotherapy
Background:
- Brain metastasis from differentiated thyroid cancer (DTC) is a growing concern.
- Understanding the characteristics and treatment of DTC brain metastases is crucial.
Purpose of the Study:
- To analyze patients with brain metastases from DTC.
- To identify factors influencing survival and treatment outcomes.
Main Methods:
- Retrospective review of 22 DTC patients with brain metastases (2000-2020).
- Analysis of patient characteristics, histology, treatments, and survival data.
- Kaplan-Meier analysis to compare survival curves based on clinical factors and treatments.
Main Results:
- Brain metastases occurred in 1.09% of DTC patients.
- Median survival was 17.5 months post-diagnosis.
- Performance status, tumor site, and neurosurgery significantly impacted survival.
- Skull metastases had a better prognosis than intracranial types.
- Neurosurgery was the only treatment significantly improving overall survival (OS).
Conclusions:
- Differentiated thyroid cancer with brain metastasis has a poor prognosis.
- Comprehensive treatment, including neurosurgery and potentially radioiodine therapy (RAIT), can improve outcomes.
- Patient performance status and metastasis location (skull vs. intracranial) are key prognostic factors.
