BACKGROUND: Treatment of patients with liver metastasis of differentiated thyroid carcinoma (DTC) has not been sufficiently defined, because liver metastasis of DTC has been described mostly as case reports. Additionally, such patients are considered end-of-treatment responders. A relatively new approach using tyrosine kinase inhibitors (TKIs) may provide opportunities to manage systemic metastasis. This study aims to define the clinical features of DTC patients with liver metastasis and evaluate the benefits of TKIs. METHODS: We retrospectively analyzed clinical features of 29 patients (mean age 67.8 years) diagnosed with liver metastasis of DTC at our institution between January 1981 and May 2017. RESULTS: All patients had distant metastasis at other organ sites upon diagnosis of liver metastasis; 41% of them developed new metastasis afterward. Management after diagnosis of liver metastasis comprised palliative care (48%), radioactive iodine therapy (28%), and TKI therapy (24%). The median survival after diagnosis of liver metastasis was only 4.8 months. Survival rates were significantly better in patients with performance statuses between 0 and 2 on the Eastern Cooperative Oncology Group scale at diagnosis of liver metastasis (n = 22, 76%) treated with TKI compared to those who were not (P = 0.017; log-rank test; hazard ratio 0.19). One-year survival rates were 71.4 and 26.7% for patients treated with or without TKI, respectively. CONCLUSIONS: Patients with liver metastasis had poor clinical prognosis. When other distant metastases existed at diagnosis of liver metastasis, TKI therapy was considered an effective therapeutic option for patients with liver metastasis of DTC.
BACKGROUND: Treatment of patients with liver metastasis of differentiated thyroid carcinoma (DTC) has not been sufficiently defined, because liver metastasis of DTC has been described mostly as case reports. Additionally, such patients are considered end-of-treatment responders. A relatively new approach using tyrosine kinase inhibitors (TKIs) may provide opportunities to manage systemic metastasis. This study aims to define the clinical features of DTCpatients with liver metastasis and evaluate the benefits of TKIs. METHODS: We retrospectively analyzed clinical features of 29 patients (mean age 67.8 years) diagnosed with liver metastasis of DTC at our institution between January 1981 and May 2017. RESULTS: All patients had distant metastasis at other organ sites upon diagnosis of liver metastasis; 41% of them developed new metastasis afterward. Management after diagnosis of liver metastasis comprised palliative care (48%), radioactive iodine therapy (28%), and TKI therapy (24%). The median survival after diagnosis of liver metastasis was only 4.8 months. Survival rates were significantly better in patients with performance statuses between 0 and 2 on the Eastern Cooperative Oncology Group scale at diagnosis of liver metastasis (n = 22, 76%) treated with TKI compared to those who were not (P = 0.017; log-rank test; hazard ratio 0.19). One-year survival rates were 71.4 and 26.7% for patients treated with or without TKI, respectively. CONCLUSIONS:Patients with liver metastasis had poor clinical prognosis. When other distant metastases existed at diagnosis of liver metastasis, TKI therapy was considered an effective therapeutic option for patients with liver metastasis of DTC.
Authors: Marcia S Brose; Christopher M Nutting; Barbara Jarzab; Rossella Elisei; Salvatore Siena; Lars Bastholt; Christelle de la Fouchardiere; Furio Pacini; Ralf Paschke; Young Kee Shong; Steven I Sherman; Johannes W A Smit; John Chung; Christian Kappeler; Carol Peña; István Molnár; Martin J Schlumberger Journal: Lancet Date: 2014-04-24 Impact factor: 79.321
Authors: Y Mizukami; T Michigishi; A Nonomura; T Hashimoto; S Terahata; M Noguchi; K Hisada; F Matsubara Journal: Hum Pathol Date: 1990-03 Impact factor: 3.466
Authors: Martin Schlumberger; Makoto Tahara; Lori J Wirth; Bruce Robinson; Marcia S Brose; Rossella Elisei; Mouhammed Amir Habra; Kate Newbold; Manisha H Shah; Ana O Hoff; Andrew G Gianoukakis; Naomi Kiyota; Matthew H Taylor; Sung-Bae Kim; Monika K Krzyzanowska; Corina E Dutcus; Begoña de las Heras; Junming Zhu; Steven I Sherman Journal: N Engl J Med Date: 2015-02-12 Impact factor: 91.245
Authors: Brian Hung-Hin Lang; Kai Pun Wong; Chung Yeung Cheung; Koon Yat Wan; Chung-Yau Lo Journal: Ann Surg Oncol Date: 2012-10-28 Impact factor: 5.344
Authors: Maxime Herchuelz; Gwennaëlle Marin; Ivan Duran Derijckere; Michaël Vouche; Philippe Delatte; Vincent Donckier; Gabriel Liberale; Alain Hendlisz; Carlos Artigas; Pierre Bourgeois; Patrick Flamen Journal: Radiol Case Rep Date: 2020-03-12