title: Evaluation of Prognostic Factors Associated With Differentiated Thyroid Carcinoma With Pulmonary Metastasis.
abstract: BACKGROUND
  Because one of the major sites for metastasis of thyroid cancers is the lung, studying the pattern of pulmonary metastasis may provide useful information for the effective treatment of these patients. In this study, by assessing the metastasis pattern, we aimed to identify the factors that may affect prognosis and response to treatment in patients with differentiated thyroid carcinoma (DTC) with pulmonary metastasis.
  
  
  METHODS
  This retrospective study included 75 patients with DTC with pulmonary metastasis who were referred to our nuclear medicine section over a period of 10 years. The data obtained were analyzed with regard to response to treatment to assess the effects of the included factors on prognosis.
  
  
  RESULTS
  Of the 1746 patients referred to our section, 75 (4.3%) had pulmonary metastasis. According to the pattern of pulmonary metastasis, they were divided into 4 groups: nodular, diffuse, combined, and other. The mean age of the patients was 43.8 ± 18.5 years. After the follow-up, 58 patients survived, 14 of whom responded to the treatment. The mean number of radioiodine therapy sessions that the patients received was 3.2 ± 2, and the mean cumulative dose was 554.7 ± 387.8 mCi. Statistical analysis of the data revealed that there was no significant difference in the response to treatment between patients with different patterns of pulmonary metastasis (P > 0.3). However, significant differences were reported in the response to treatment between patients with papillary thyroid carcinoma and those with follicular thyroid carcinoma (P < 0.03). The 1-, 5-, and 9-year survival rates were reported as 98%, 76%, and 51%, respectively.
  
  
  CONCLUSIONS
  Patients with DTC with pulmonary metastasis have a relatively favorable prognosis and response rate, as well as longer survival. The type of DTC is the only factor that affects the response to treatment.
authors.affiliation: From the *Department of Nuclear Medicine, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran; †Department of Nuclear Medicine, Shohada-e-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran; ‡The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr; and §Golestan Research Center of Gastroenterology and Hepatology (GRCGH), Golestan University of Medical Sciences, Gorgan, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Qutbi
authors.forename: Babak
authors.initials: B
authors.lastname: Shafeie
authors.forename: Mahasti
authors.initials: M
authors.lastname: Amoui
authors.forename: Faraj
authors.initials: F
authors.lastname: Tabeie
authors.forename: Zahra
authors.initials: Z
authors.lastname: Azizmohammadi
authors.forename: Ali
authors.initials: A
authors.lastname: Mahmoud-Pashazadeh
authors.forename: Hamid
authors.initials: H
authors.lastname: Javadi
authors.forename: Majid
authors.initials: M
authors.lastname: Assadi
authors.forename: Isa Neshandar
authors.initials: IN
authors.lastname: Asli
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology*; D002291:Carcinoma, Papillary; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008175:Lung Neoplasms / Q000532:radiotherapy / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes