Spinal metastasis in thyroid cancer

Ramadan, Sami; Ugas, Mohamed A; Berwick, Richard J; Notay, Manisha; Cho, Hyongyu; Jerjes, Waseem; Giannoudis, Peter V

doi:10.1186/1758-3284-4-39

Head & Neck Oncology

Table 3 Summary results of studies that deployed conventional therapeutic modalities in patients with distant metastasis from thyroid carcinoma

From: Spinal metastasis in thyroid cancer

Author, Year	Number of patients (% female)	Median age (yrs) at time of symptomatic distant metastatic disease (range)	Thyroid cancer histology (%)	Percentage of Patients with bone/spinal metastasis	Signs and symptoms of distant metastasis/indication for intervention	Intervention for distant metastasis (% of patients)	Other metastases (%)	Main outcome(s)
Schlumberger et al., 1999	394 (61.7%)	-	PWD (46.1%), FWD (7.5%), FLD (46.3%)	BM (27.4%), BM + Lung (18.3%)	Pain, swelling, orthopaedic complications	RAI (88%), ERT (35%), surgery (18%), CT (12%)	Lung (54.3%)	5 year/10 year/15 year survival: 55%/40%/33%
Pittas et al. 2000	146 (58%)	58.7	PWD (13%), FWD (12%), Hurthle (6%), UTC (7), PDTC (13%), medullary (4%), lymphoma (2%), unknown (43%)	BM (100%), SM (54%)	Pain (50%), swelling (11.0%), pathologic fracture (4.1%), SCC (3.4%)	RAI (51%), ERT (75%), Surgery (26%), CT (12%)	Other (36%)	5 yr/10 yr survival: 53%/35%
Bernier et al., 2001	109 (71%)	63 (20–87)	PWD (17%), FWD (71%), Unknown (12%)	BM (100%), SM (68%)	Pathological fractures (13%), Radiculalgia (4%), SCC (28%), SCC + fracture (6%r	Complete BM surgery (22%), palliative surgery (55%), ERT (36%), SET (31%), CT (2%)	Lung (34%), thyroid (11.%), other (25%)	5 yr/10 yr/20 yr survival rate: 41%/15%/7%, Mean survival 5.6 years. Remission rate 4%, Mortality 84%
Petrich et al., 2001	107 (28.0%)	62.1	PWD (27.1%), FWD (72.9%)	BM (100%)	-	RAI (100%), ERT (14%)	Lung (41.1%)	CR 25 (23.4%), PR 29 (27.1%), PD 53 (49.5%), Mean survival 7.9 yr
Stojadinovic et al., 2002	260 (51.2%)	58 (5–91)	PWD (58.8%), FWD (34.2%), Hurthle (6.9%)	BM (15%)	-	Surgery (22.7%), + RAI (13.8%), RAI +/− other (54.2%), Other (ERT, CT, supportive) (23.1%)	Lung (32.7%), single site 59 (22.7%), multisite 77 (29.6%)	5 yr DSS: Complete metastasectomy 78%, Partial resection 43%, Non-operative treatment 46%
Zettinig et al., 2002	41 (58.5%)	60 +/− 12	PWD (14.6%), FWD (85.4%)	BM (100%)	Pain (37%), goitre/nodules (51%), dyspnoea (10%)	Surgery (51.2%), RAI (78%), ERT (27%), CT (6%)	-	5 yr/10 yr survival: 69.2%/38.9%
Durante et al., 2006	444 (62%)	-	PWD (42%), FWD (15%), FPD (41%)	BM (26%), BM and lung (18%)	-	RAI + CT, EBR and/or surgery in indicated BM patients	Lung (52%), other (5%)	10 yr survival in negative and abnormal study patients, 92% and 19%, respectively. BM only patients required median cumulative I-131 dose of 250 mCi to attain negative studies
Orita et al., 2010	52 (65.4%)	59 (32–77)	PWD (52%), FWD (48.%)	BM (100%)	Pain (46.2%), mass bone lesions (9.6%), paralysis/numbness (7.7%), fracture (3.8%)	Surgery (21.2%), ERT (75%), RAI (75%), CT (7.7%), Bisphosphonate (34.6%), TSH suppression (36.5%)	Lung (44.2%), pleura (9.6%), brain (5.8%), liver (3.8%)	5 yr/10 yr DSS: 36%/10%
Qiu et al., 2011	106 (62%)	53 (12–85)	PWD (41.5%), FWD (49.1%), Follicular variant of Papillary (9.4%)	BM (45.3%), BM + other (54.7%)	Pain (57.5%), pathological fracture (5.7%), SCC (4.7%)	Oral RAI (100%), Surgery (24.5%)	Cervical lymph nodes (16.0%), lung (42.%), other (20%)	5 yr/10 yr survival rate: 86.5%/57.9%

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, yr; year.

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