Prognostic Factors in Thyroid Cancer Patients With Brain Metastases: A Systematic Review and Meta-Analysis

Area of Science:

• Oncology
• Neurology
• Medical Statistics

Background:

• Brain metastases from thyroid cancer (TC) are infrequent but indicate advanced disease with poor prognosis.
• Identifying prognostic factors for brain metastasis-specific survival (BMS) is crucial for managing this patient group.

Purpose of the Study:

• To identify key prognostic factors associated with brain metastasis-specific survival (BMS) in patients with thyroid cancer brain metastases.
• To inform clinical management and improve outcomes for patients with advanced thyroid cancer.

Main Methods:

• Systematic review and meta-analysis of studies retrieved from major databases (PubMed, Scopus, Embase, MEDLINE).
• Multivariable Cox proportional hazards model used to estimate hazard ratios (HRs) for prognostic factors.
• Inclusion of 24 studies with a total of 301 patients.

Main Results:

• Median BMS was 18 months.
• Factors significantly decreasing BMS included anaplastic thyroid carcinoma (HR, 3.3), poorly differentiated thyroid carcinoma (HR, 1.95), poor performance status (ECOG >1) (HR, 2.62), multiple brain metastases (HR, 1.89), and distant metastases (HR, 1.97).
• Tumor size and location were not significantly associated with BMS.

Conclusions:

• Thyroid cancer with brain metastases carries a poor prognosis.
• Aggressive tumor subtypes, poor performance status, multiple brain metastases, and extracranial metastases (especially lung) are key negative prognostic factors.
• A multidisciplinary approach and effective systemic disease control are essential for improving outcomes.