Survival rate (SR) in patients (pts) diagnosed (dx’ed) with well-differentiated thyroid cancer (WDTC) with bone metastases (BMs)

Objectives Reports of 5-year SR in pts with WDTC vary widely from 7%-65%. However, since publication of those reports, many additional treatments (txs) combined with or without I-131 have been utilized more frequently in pts with WDTC BMs. Thus, re-evaluation of the SR in pts tx’ed with various combinations of these tx modalities is warranted. The objective of this study is to determine the SRs in pts who have WDTC BM dx’ed since 2001 and were tx’ed with more current modalities.

Methods Pts with the following criteria were evaluated retrospectively: (1) WDTC,(2) tx'ed at least once at WHC, (3) BM first dx’ed after 1 Jan 2001, and (4) follow-up data of pts available through Nov 2009. The data tabulated included (1) original dx date, age, gender, extent of surgery, stage, histology, extent of disease, (2) the date and site of initial dx of WDTC BM, (3) all txs prior to and after the dx of WDTC BM including I-131 txs with or without dosimetry, amounts of I-131, surgical excision, external radiotherapy, radiofrequency ablation, cryotherapy, arterial embolization, and/or chemotherapy, etc., and (4) status of pt through Nov 2009. SRs were determined for 1, 2, 3, and 5 yrs.

Results Data on 26 pts were available. The mean, range, and standard deviation for follow-up were 3.3, 0.47-8.84, and 2.4 yrs, respectively. The pt specific data and tx modalities are presented. The SR at 1, 2, 3, and 5 yrs were 24/24(100%), 15/16(94%), and 12/14(86%), and 7/9(78%), respectively.

Conclusions The analysis indicates that the 5-yr SR of pts who have WDTC with bone metastases is higher (~78%) after tx by a combination of the aforementioned modalities after 200l relative to earlier data indicating SRs of 7%-65% for pts tx’ed prior to 2001. However, further study is warranted to determine if this apparent improvement is secondary to factors such as the tx modalities used, site of BMs, different pt populations, and/or earlier dx and tx of BMs