title: Different features of pulmonary metastases in differentiated thyroid cancer: natural history and multivariate statistical analysis of prognostic variables.
abstract: We studied 134 patients with differentiated thyroid cancer and pulmonary metastases. All were treated with total or near total thyroidectomy, radioiodine and L-thyroxine. The prognostic value of the following variables in three groups of patients were evaluated by univariate and multivariate analysis: age at diagnosis, sex, histologic type, tumor extension, cervical lymph node metastases, mediastinic metastases, presence of metastases in distant sites other than lungs (multiple distant metastases) and morphological (chest x-rays) and functional (131I uptake) features of lung metastases. Univariate analysis identified patient age (p < 0.0001), morphological and functional features of lung metastases (p < 0.0001), presence of multiple distant metastases (p < 0.0001) and histologic type (p = 0.04) as significant prognostic factors. Multivariate analysis showed only morphological (p = 0.0014) and functional (p < 0.0001) features of lung metastases and the presence of multiple distant metastases (p = 0.01) as significant and independent variables. The data show that early (pre-radiological) scintigraphic diagnosis and 131I therapy of lung metastases appear to be the most important elements in obtaining both a significant improvement in survival rate and a prolonged disease-free time interval in these patients.
authors.affiliation: Department of Radiotherapy and Nuclear Medicine, General Hospital of Padua, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Casara
authors.forename: D
authors.initials: D
authors.lastname: Rubello
authors.forename: G
authors.initials: G
authors.lastname: Saladini
authors.forename: G
authors.initials: G
authors.lastname: Masarotto
authors.forename: A
authors.initials: A
authors.lastname: Favero
authors.forename: M E
authors.initials: ME
authors.lastname: Girelli
authors.forename: B
authors.initials: B
authors.lastname: Busnardo
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000401:mortality / Q000556:secondary / Q000628:therapy; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002291:Carcinoma, Papillary / Q000401:mortality / Q000556:secondary / Q000628:therapy; D002648:Child; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality* / Q000556:secondary* / Q000628:therapy; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011877:Radionuclide Imaging; D017678:Sex Distribution; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000473:pathology*