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Table 2 Clinical characteristics at diagnosis of patients with spinal metastasis from thyroid carcinoma and the therapeutic strategies deployed

From: Spinal metastasis in thyroid cancer

Author, Year Patient No. Age (yrs), sex at time of symptomatic spine disease Thyroid cancer histology TNM stage Intervention for primary site Location of spinal metastasis Signs + symptoms of spinal metastasis/indication for surgery Intervention for spinal metastasis Outcome at last follow-up (months)
Quan et al., 2012 1 76, F FWD T2 N0 M1 Total thyroidectomy followed by 131-I (100 mCi) therapy every 3–9 months for 2 years then once a year till disappearance of metastatic uptake L3 Intractable pain resistant to non-operative measures and pain and/or paralysis due to bony instability or spinal cord compression by metastatic tumour L1-4 decompression and stabilization AWD (60)
2 76, F FWD T4 N0 M1 Lumbar L4-5 decompression and stabilization AWD (56)
3 60, F PWD T1 N0 M1 L4 L3-5 decompression and stabilization AWD (20)
4 67, F FWD T4 N1 M1 Thoracic T3 anterior corpectomy and reconstruction with cement and anterior plate CR (96)
5 45, M Papillary PDTC, refractory to I-131 T3 N0 M0 Thoracic Intractable pain focal mechanical pain resistant to non-operative measures and due to osteolytic metastases in the absence of significant spinal cord compression or spinal instability. T8 vertebroplasty, followed by T8-T9 decompression and then T6, T7, and L3 vertebroplasties DOD (6)
6 70, F PWD T3 N0 M1 Thoracic T9 and L1 vertebroplasty AWD (48)
7 61, F PWD T3 N1 M0 Cervical C3, non-operative AWD (17)
8 68, F MTC T4 N0 M1 Total thyroidectomy Thoracic T12 vertebroplasty DOD (18)
Demura et al., 2011 1 55, F Follicular - 7/10 patients had undergone previous total thyroidectomy. Subtotal thyroidectomy was performed in 2 patients. Emergency spinal surgery (TES) was performed due to acute paraparesis in 1 case, followed by total thyroidectomy. Preoperatively, 131-I therapy had been administered in 4 cases (patient 2, 3, 5, and 9); all 4 of these patients showed a poor response to the treatment. L2 Preserved motor function, abnormal gait and muscle weakness SET, TES & intraoperative chemotherapy DOD (77)
2 56, F Follicular - T7 Preserved motor function and normal gait SET, TES & intraoperative chemotherapy NED (125)
3 58, F Papillary - T2 Preserved motor, non-functional SET, TES & intraoperative chemotherapy DOD (27)
4 56, F Follicular - L2 Normal motor function SET, TES & intraoperative chemotherapy AWD (86)
5 59, M Papillary - T10 Normal motor function SET, TES & intraoperative chemotherapy DOD (62)
6 63, F Follicular - T10-11 Preserved motor, non-functional SET, TES & intraoperative chemotherapy AWD (56)
7 39, F Medullary - T2, T5-7 Normal SET, TES & intraoperative chemotherapy AWD (52)
8 77, F Follicular - T7, T10 Preserved motor function, abnormal gait and muscle weakness and bladder paralysis SET, TES & intraoperative chemotherapy AWD (45)
9 57, F Follicular - T11 Normal motor function SET, TES & intraoperative chemotherapy AWD (36)
10 52, F Papillary - L2-4 Normal motor function SET, TES & intraoperative chemotherapy NED (36)
De Vries et al., 2008 1 60, F FWD T1 N0 M1 Total thyroidectomy and I-131 therapy L4 Pain and neurological symptoms SET, external beam radiotherapy & corporectomy L4 Symptoms decreased during 17 sessions (mean duration of 8.1 months), were unchanged during 8 sessions, and increased during 6 sessions (p < 0.01).
2 62, F FWD T2 N0 M1 T5-7 Pain and neurological symptoms SET & external beam radiotherapy
3 65, F FWD T2 N0 M1 L3- 4 Pain and neurological symptoms SET
4 40, F FWD T4 N0 M1 L5 Pain and neurological symptoms SET & external beam radiotherapy
5 77, F FWD T2 N0 M1 L2 Pain and neurological symptoms SET & external beam radiotherapy
6 54, F FWD T2 N0 M0 T10-11 Pain and neurological symptoms SET & external beam radiotherapy
7 35, M FWD Tx N0 M0 L2-4 Pain and neurological symptoms SET & external beam radiotherapy
8 52, F FWD Tx N0 M1 L3 Pain and neurological symptoms SET & corporectomy L3
9 45, F FWD T3 N0 M1 C4 Pain and neurological symptoms SET & corporectomy C4
10 83, M FWD Tx N0 M1 C5-6 Pain and neurological symptoms SET & surgical C5–C6
Hindie í et al., 2007 1 27, F FWD (Hurthle areas) T2 NX Total thyroidectomy and 131-I ablation therapy (100 mCi) T2 Back pain Spinal surgery + radiotherapy PR (43)
2 34, F PWD T3 NX L4 Asymptomatic, metastases revealed via 131-I ablation therapy - CR (8)
3 48, M PWD T1 NX T6, L2 Asymptomatic, metastases revealed via 131-I ablation therapy - CR (37)
4 53, M Follicular, PDTC T4a N1b T6 Back pain Spinal surgery + radiotherapy DOD (76)
5 55, M PWD (Hurthle areas) T1 Nx T11, L3 Asymptomatic, metastases revealed via 131-I ablation therapy - CR (23)
6 63, F FWD T2 NX T10-11 Back pain Spine radiotherapy DOD (32)
7 75, F FWD T3 N0 T12 Back pain Spinal surgery + radiotherapy PD (62)
8 65, F PWD T4b N1b C6 Asymptomatic, metastases revealed via 131-I ablation therapy Spine radiotherapy DOD (34)
9 73, M Hürthle T3 N1b Cervical Bone pain Spine radiotherapy DOD (5)
Eustatia-Rutten et al., 2003 1 69, M FTC, DTC T4 N1 M1 Total thyroidectomy and 131-I ablation therapy (76–162 mCi) ± second 131-I therapy, irradiation and/or laminectomy L1-4 Radicular pain/SSC, hyperaesthesia SET and 131-I ablation therapy (76–162 mCi), laminectomy and irradiation DOD (54)
2 51, M FTC Tx Nx M0 T1 Radicular pain SET DOD (124)
3 72, F PTC T4 N0 M1 T1 Paresis, incontinence SET then laminectomy & irradiation DOD (1.5)
4 71, F PTC T4 N0 M1 L3 Radicular pain/SSC, SET then irradiation PD (139)
5 62, M FTC T4 N0 M0 T10, T12 Radicular pain SET DOD (63)
6 60, M FTC T2 N0 M1 C7 SSC, paraplegia, radicular pain SET then 131-I therapy (76–162 mCi) and irradiation DOD (86)
7 53, F FTC T2 N0 M0 L1 Radicular pain, hyperaesthesia, paraesthesia SET PD (108)
8 45, M FTC T3 N0 M0 T1-3, T5-7 Radicular pain, paraparesis, ataxia, paraplegia SET then 131-I ablation therapy (76–162 mCi), laminectomy and irradiation PD (152)
9 72, M PTC Tx N1 M1 T9-10 Radicular pain, SET DOD (12)
10 62, M PTC T3 N0 M0 T9-10 paraparesis, incontinence, hyperaesthesia, paraplegia, radicular pain SET DOD (102)
van Tol et al., 2000 1 77, F PWD T2 N1 M1 Total thyroidectomy and 131-I ablation therapy (150 mCi) L2 Severe pain and neurological symptoms SET then 131-I therapy (150 mCi) AWD (40)
3 63, F FWD T2 N0 M1 T7 Severe pain, neurological symptoms and SCC SET then 131-I therapy (150 mCi) CR (38)
4 60, F FWD T2 N0 M1 L4 Severe pain, neurological symptoms and SCC SET then 131-I therapy (150 mCi) CR (21)
Vitale et al. 2001 1 35, F FWD - Not specified; failure of all conventional therapy Spine Painful bone metastases 1 year monthly course of I.V. pamidronate (90 mg) PR (12)
  2 76, F PWD -   Spine Painful bone metastases 1 year monthly course of I.V. pamidronate (90 mg) AWD (12)
  3 48, F FWD -   Spine Painful bone metastases 1 year monthly course of I.V. pamidronate (90 mg) PR (12)
  4 46, F FWD -   Spine Painful bone metastases 1 year monthly course of I.V. pamidronate (90 mg) AWD (12)
  5 54, F MTC -   Spine Painful bone metastases 1 year monthly course of I.V. pamidronate (90 mg) PD (12)
  6 66, F MTC -   Spine Painful bone metastases 7 monthly course of I.V. pamidronate (90 mg) PD (12)
  7 61, M FWD -   Spine Painful bone metastases 1 year monthly course of I.V. pamidronate (90 mg) AWD (12)
  1. DTC; differentiated thyroid carcinoma, PWD; papillary well differentiated, FWD; follicular well differentiated, MTC; medullary thyroid carcinoma, PDTC; poorly differentiated thyroid carcinoma, FLD; follicular less differentiated, UTC; undifferentiated thyroid carcinoma, T; thoracic, L; lumbar, C; cervical, BM; bone metastasis, SM; spinal metastasis, SSC; spinal cord compression, RAI; radioactive iodine (131-I), ERT; external radiotherapy, CT; chemotherapy, SET; selective embolization therapy, TES; total en bloc spondylectomy, ZA; zolendronic acid, NED; no evidence of disease, SD; stable disease, CR; complete remission, PR; partial response, PD; progressive disease, AWD; alive with disease, DOD; death of disease, SRE; skeletal-related events, PFS; progression-free survival, DSS; disease-specific survival, Yrs; years.
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Head & Neck Oncology

ISSN: 1758-3284