Clinical Management and Outcomes in Patients with Hyperfunctioning Distant Metastases from Differentiated Thyroid Cancer After Total Thyroidectomy and Radioactive Iodine Therapy
Clinical Management and Outcomes in Patients with Hyperfunctioning Distant Metastases from Differentiated Thyroid Cancer After Total Thyroidectomy and Radioactive Iodine Therapy
复制标题
甲状腺全切除术和放射性碘治疗后分化型甲状腺癌远处转移功能亢进患者的临床管理和结果
DOI：
10.1089/thy.2014.0233
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发表时间：
2015-02-01
期刊：
影响因子：
6.6
通讯作者：
Luo, Quan-Yong
中科院分区：
文献类型：
--
作者：
Qiu, Zhong-Ling;Shen, Chen-Tian;Luo, Quan-Yong
Background: Hyperfunctioning distant metastasis (HFDM) from differentiated thyroid cancer (DTC) is a rare entity. This study aimed to assess the outcomes of DTC patients presenting with HFDM after total thyroidectomy and radioactive iodine therapy.Methods: A total of 5367 DTC patients treated with I-131 after total thyroidectomy were analyzed retrospectively from January 1991 to June 2013. Therapeutic efficacy was evaluated based on changes in serum thyroglobulin (Tg) and anatomical imaging changes in metastatic lesions. The relationships between survival time and several variables were assessed by univariate and multivariate analyses using the Kaplan-Meier method and Cox's proportional hazards model respectively.Results: Thirty-eight patients with HFDM from DTC were diagnosed, including four with hyperthyroidism, four with subclinical hyperthyroidism, and three with subclinical hypothyroidism. The remaining 27 were euthyroid. Of 25 patients with lung metastases, 84% (21/25) showed disappearance or shrinkage of lung nodules; of 24 patients with bone metastases, 66.67% (16/24) exhibited no obvious imaging changes in metastatic bone lesions after I-131 therapy. Serum Tg decreased significantly in 81.58% (31/38) and increased in 18.42% (7/38) after I-131 therapy. The 10-year survival rate of DTC patients with HFDM was 65.79% (25/38). Multivariate analyses identified age at occurrence of distant metastases (
