Ana Kober N Leite1, Beatriz G Cavalheiro1, Marco Aurélio Kulcsar1, Ana de Oliveira Hoff2, Lenine G Brandão3, Claudio Roberto Cernea3, Leandro L Matos1. 1. Divisão de Cirurgia de Cabeça e Pescoço, Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, Brasil. 2. Departamento de Endocrinologia, Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, Brasil. 3. Divisão de Cirurgia de Cabeça e Pescoço, Faculdade de Medicina da Universidade de São Paulo (FMUSP).
Abstract
OBJECTIVE: The present study describes the clinical and tumor characteristics of patients that died from differentiated thyroid cancer and reports on the cause and circumstances of death in these cases. SUBJECTS AND METHODS: Retrospective analysis of all the differentiated thyroid cancer (DTC) related deaths at a single institution over a 5-year period, with a total of 33 patients. RESULTS: Most of the patients were female (63.6%), with a mean age at diagnosis of 58.2 years. The most common histologic type was papillary (66.7%) and 30.3% were follicular. The distribution according to the TNM classification was: 15.4% of T1; 7.7% T2; 38.4% T3; 19.2% of T4a and 19.2% of T4b. Forty-four percent of cases were N0; 20% N1a and 36.6% of N1b. Twelve patients were considered non-responsive to radioiodine. Only one of the patients did not have distant metastases. The most common metastatic site was the lung in 69.7%. The majority of deaths were due to pulmonary complications related to lung metastases (17 patients, 51.5%), followed by post-operative complications in 5 cases, neurological disease progression in 3 cases, local invasion and airway obstruction in one patient. Median survival between diagnosis and death was reached in 49 months while between disease progression and death it was at 22 months. CONCLUSION: Mortality from DTC is extremely rare but persists, and the main causes of death derive from distant metastasis, especially respiratory failure due to lung metastasis. Once disease progression is established, median survival was only 22 months.
OBJECTIVE: The present study describes the clinical and tumor characteristics of patients that died from differentiated thyroid cancer and reports on the cause and circumstances of death in these cases. SUBJECTS AND METHODS: Retrospective analysis of all the differentiated thyroid cancer (DTC) related deaths at a single institution over a 5-year period, with a total of 33 patients. RESULTS: Most of the patients were female (63.6%), with a mean age at diagnosis of 58.2 years. The most common histologic type was papillary (66.7%) and 30.3% were follicular. The distribution according to the TNM classification was: 15.4% of T1; 7.7% T2; 38.4% T3; 19.2% of T4a and 19.2% of T4b. Forty-four percent of cases were N0; 20% N1a and 36.6% of N1b. Twelve patients were considered non-responsive to radioiodine. Only one of the patients did not have distant metastases. The most common metastatic site was the lung in 69.7%. The majority of deaths were due to pulmonary complications related to lung metastases (17 patients, 51.5%), followed by post-operative complications in 5 cases, neurological disease progression in 3 cases, local invasion and airway obstruction in one patient. Median survival between diagnosis and death was reached in 49 months while between disease progression and death it was at 22 months. CONCLUSION: Mortality from DTC is extremely rare but persists, and the main causes of death derive from distant metastasis, especially respiratory failure due to lung metastasis. Once disease progression is established, median survival was only 22 months.
Authors: Angelica Perna; Antonio De Luca; Laura Adelfi; Tammaro Pasquale; Bruno Varriale; Teresa Esposito Journal: BMC Complement Altern Med Date: 2018-02-15 Impact factor: 3.659