Publicaciones científicas
Bone metastasis in differentiated thyroid cancer: Spanish multicenter study of clinical characteristics, survival and prognostic factors
Suset Dueñas-Disotuar 1 , Ana Piñar-Gutiérrez 1 , Irene de Lara-Rodríguez 1 , Julia Sastre-Marcos 2 , Emma Anda-Apiñániz 3 , Amelia Oleaga-Alday 4 , Juan Carlos Galofré-Ferrater 5 , Aida Orois-Añon 6 , Victoria Alcázar-Lázaro 7 , Laia Martínez-Guasch 8 , Cecilia Sánchez-Ragnarsson 9 , María Ángeles Gálvez-Moreno 10 , Cristina Familiar-Casado 11 , Tomás Martín-Hernández 12 , Ana R Romero-Lluch 1
Objective: This study describes the characteristics, survival and prognostic factors in a cohort of patients with bone metastases (BM) from differentiated thyroid carcinoma (DTC).
Methods: This was a multicenter retrospective observational study conducted in Spain, including patients diagnosed with DTC and BM between 1980 and 2022. A Cox regression analysis was performed to examine prognostic factors for survival. Kaplan-Meier and log-rank tests were performed for survival analysis and comparison between groups.
Results: A total of 133 patients were included with a median follow-up of 40 (17-70) months. Seventy patients (52.6%) had BM at the initial diagnosis. Fifty-two (39.1%) had follicular carcinoma. Sixty-six (49.6%) presented multiple BM. The most frequent location was the spine (63.2%). Other metastases were present at diagnosis in 88 (66.2%), mainly lung (60.9%). BM were treated with I131 in 91 (68.4%) patients, with BM uptake in 63 (47.4%). Fifty-six (42.1%) received treatment with multikinase inhibitors. Fifty-three (3.9%) had skeletal-related events. Seventy-two (54.1%) died. The 3-, 5- and 10-year survival was 53.5, 39.5% and 28.5%, respectively. Significant prognostic factors in the multivariate analysis were the presence of lymph node metastases (N1) HR 1.71 (95% CI 1.005-2.098; p=0.048), BM treatment with I131 HR 0.532 (95% CI 0.304-0.931; p=0.027) and age ≥67 years at BM diagnosis HR 1.991 (95% CI 1.142-3.47; p=0.015).
Conclusions: Survival of DTC patients with BM treated in a Spanish cohort was 39.5% at 5 years and 28.5% at 10 years. Patients with BM treated with I131 appear to have a better outcome in terms of mortality and the presence of lymph node involvement and age over 67 years were associated with higher mortality.
CITA DEL ARTÍCULO Front Endocrinol (Lausanne). 2024 Nov 7:15:1466245. doi: 10.3389/fendo.2024.1466245. eCollection 2024
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