Bone metastases from thyroid carcinoma: Clinical characteristics and prognostic variables in one hundred forty-six patients
Bone metastases from thyroid carcinoma: Clinical characteristics and prognostic variables in one hundred forty-six patients
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DOI：
10.1089/thy.2000.10.261
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发表时间：
2000-03-01
期刊：
影响因子：
6.6
通讯作者：
Robbins, RJ
中科院分区：
文献类型：
--
作者：
Pittas, AG;Adler, M;Robbins, RJ
描述甲状腺癌骨转移患者的临床特征并确定最佳预测生存的指标。我们收集了146例甲状腺癌骨转移患者的医疗记录数据，这些患者在我们的医疗中心接受了38年的治疗。对生存预后指标进行单变量和多变量分析。47%的患者在初次诊断时存在骨转移。脊椎（29%）、骨盆（22%）、肋骨（17%）和股骨（11%）是最常见的转移部位。53%的病例存在多处病变。从甲状腺癌诊断开始的10年总生存率为35%，从最初的骨转移诊断开始的10年总生存率为13%。通过单因素分析，从最初的骨转移的时间，放射性碘吸收骨转移，非骨转移的情况下，放射性碘治疗是显着的预后因素。通过多变量分析，骨转移瘤的放射性碘摄取和无非骨转移是生存的独立有利预后变量。在可获得组织学标本并进行回顾的患者亚组中，Hurthle细胞癌是最有利于生存的组织学亚型，未分化亚型最差。甲状腺癌扩散到骨更常见于45岁以上的患者，通常有症状，并且通常是多中心的。总生存率最好的是那些病变集中放射性碘和那些谁没有非骨转移。
To describe the clinical characteristics and define the indicators that best predict survival in patients with bone metastases from thyroid carcinomas. We collected data from medical records of 146 patients with documented bone metastases from thyroid carcinoma seen at our medical center over a 38-year period. Univariate and multivariate analyses of prognostic indicators for survival were performed. Bone metastases were present at the initial diagnosis in 47% of patients. Vertebrae (29%), pelvis (22%), ribs (17%), and femur (11%) were the most common sites of metastases. Multiple lesions were present in 53% of the cases. The overall 10-year survival rate from the time of diagnosis of thyroid cancer was 35%, and from diagnosis of initial bone metastasis was 13%. By univariate analysis from the time of the initial bone metastasis, radioiodine uptake by skeletal metastases, the absence of nonosseous metastases and treatment with radioiodine were significant prognostic factors. By multivariate analysis, radioiodine uptake by skeletal metastases and the absence of nonosseous metastases were independent favorable prognostic variables for survival. In a subgroup of patients in which histologic specimens were available and were reviewed, Hurthle cell carcinoma was the most favorable histologic subtype for survival with the undifferentiated subtype being the worst. The spread of thyroid carcinoma to bone is more common in patients over 45 years of age, is usually symptomatic, and is often multicentric. Overall survival is best in those whose lesions concentrate radioactive iodine and those who have no nonosseous metastases.