The role of operations for distantly metastatic well-differentiated thyroid carcinoma

Alexander Stojadinovic, Margo Shoup, Ronald A. Ghossein*, Aviram Nissan, Murray F. Brennan, Jatin P. Shah, Ashok R. Shaha

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

47 Scopus citations

Abstract

Background. The role of operations for distantly metastatic well-differentiated thyroid carcinoma (DTC) is poorly defined. We review the indications for operation for metastatic DTC. Methods. This study consists of 260 patients treated between 1941 and 2000 for metastatic DTC, of which 59 (23%) underwent operations. Median follow-up was 7 years (range, 1 to 49 years). Metastases were identified clinically in 157 (60%) and radiologically in 103 (40%) patients. The disease-specific survival was estimated with the Kaplan-Meier method. Results. Twenty-four patients (9%) were disease-free with resection. Palliative resection was indicated for painful bone metastasis, pathologic fracture, or symptomatic spinal cord involvement (35/260, 14 %). Patients who could undergo complete metastasectomy survived longer than those having incomplete/palliative resection or nonoperative treatment for metastatic DTC (5-year disease-specific survival, 78% vs 43% vs 46%, P = .03). Conclusions. Solitary distant metastasis of DTC amenable to complete resection is infrequent. Complete metastasectomy may be associated with improved survival for localized distant disease. Palliative resection is indicated to improve quality of life for symptomatic distant metastasis.

Original languageEnglish (US)
Pages (from-to)636-643
Number of pages8
JournalSurgery
Volume131
Issue number6
DOIs
StatePublished - Jan 1 2002

ASJC Scopus subject areas

  • Surgery

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