title: Prognosis After Brain Metastasis from Differentiated Thyroid Carcinoma.
abstract: BACKGROUND
  In patients with differentiated thyroid carcinoma (DTC), lung and bone metastasis sometimes occur. However, brain metastasis (BM) is extremely rare. Because most previous reports about BM from DTC included a relatively small number of cases, the clinical characteristics and outcomes of BM are still unclear.
  
  
  METHODS
  Between 1965 and 2013, among 961 patients who had died because of DTC, 24 patients were diagnosed with BM from DTC. One patient with BM from DTC is still alive. To identify the prognostic factors for longer survival after BM, the medical records of these 25 patients were retrospectively reviewed.
  
  
  RESULTS
  The median age at BM diagnosis was 66 years. Typical symptoms associated with BM had appeared in 20 patients (80%). The Karnofsky Performance Status (KPS) was good (≥70) in 10 patients and poor (≤60) in 15 patients. Seven patients had a single intracranial lesion of BM, 6 patients had 2 or 3 lesions, and 9 patients had 4 or more. Eleven patients did not receive any treatment for BM, and 14 patients underwent surgical resection, radiation therapy, or both. One-year and 5-year disease-specific survival rates were 28 and 10.6%, respectively. Good KPS (≥70), small number of intracranial lesions (≤3), and treatment for BM were prognostic factors for long survival on univariate analysis (p < 0.05). On multivariate analysis, only treatment for BM was significant.
  
  
  CONCLUSIONS
  Treatment of BM from DTC is indicated in patients who have a good KPS and fewer intracranial lesions, and some of them may achieve long survival.
authors.affiliation: Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, Japan. f-saito@ito-hospital.jp.
authors.forename: Fumi
authors.initials: F
authors.lastname: Saito
authors.affiliation: Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Uruno
authors.affiliation: Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shibuya
authors.affiliation: Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Kitagawa
authors.affiliation: Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, Japan.
authors.forename: Mitsuji
authors.initials: M
authors.lastname: Nagahama
authors.affiliation: Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, Japan.
authors.forename: Kiminori
authors.initials: K
authors.lastname: Sugino
authors.affiliation: Department of Surgery, Ito Hospital, 4-3-6 Jingumae, Shibuya-ku, Tokyo, 150-8308, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Ito
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000556:secondary*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000473:pathology*; D055815:Young Adult