title: Prognosis and prognostic factors of differentiated thyroid carcinoma after the appearance of metastasis refractory to radioactive iodine therapy.
abstract: Differentiated thyroid carcinomas (DTCs) are generally indolent, but few therapeutic strategies are available after a metastatic recurrence that is refractory to radioactive iodine (RAI) therapy. Molecular-target therapy has shown promising results for DTCs with RAI-refractory recurrence. However, not all RAI-refractory recurrences are progressive, and even those that are progressive may not be immediately life-threatening. Here we investigated the prognosis and prognostic factors of 74 DTC patients (52 females, 22 males) in whom RAI-refractory metastases appeared. The five-year and 10-year cause-specific survival (CSS) rates of the 74 patients (8-82 yrs of age; median age at the detection of metastases, 61 yrs) were 95% and 70%, respectively, and the older patients (≥ 60 yrs, n=38) and male patients were significantly more likely to die of carcinoma. Also in multivariate analysis, older age (≥ 60 years) and male gender were independent predictors of carcinoma-related death. Taken together, our data indicate that RAI-refractory metastases of older patients and male patients are more progressive than those of other patients. Further studies are necessary to clarify the appropriate indications for molecular-target therapy for RAI-refractory and progressive metastases.
authors.affiliation: Department of Surgery, Kuma Hospital, Kobe 650-0011, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ito
authors.forename: Akira
authors.initials: A
authors.lastname: Miyauchi
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ito
authors.forename: Tomonori
authors.initials: T
authors.lastname: Yabuta
authors.forename: Hiroo
authors.initials: H
authors.lastname: Masuoka
authors.forename: Takuya
authors.initials: T
authors.lastname: Higashiyama
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Fukushima
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Minoru
authors.initials: M
authors.lastname: Kihara
authors.forename: Akihiro
authors.initials: A
authors.lastname: Miya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018265:Carcinoma, Papillary, Follicular / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy*; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy*; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes