Beutner Ulrich, Leowardi Christine, Bork Ulrich, Lüthi Cornelia, Tarantino Ignazio, Pahernik Sascha, Wente Moritz N, Büchler Markus W, Schmied Bruno M, Müller Sascha A
1 Department of Surgery, Kantonsspital St. Gallen , St. Gallen, Switzerland .
Thyroid. 2015 Mar;25(3):314-24. doi: 10.1089/thy.2014.0498. Epub 2015 Jan 14.
Renal cell carcinoma can metastasize to uncommon sites, for example, the thyroid gland where metastases are rarely found. To determine the patient survival and the time between cancer diagnosis and thyroid metastasis, we analyzed a large patient cohort from our hospital records and performed a systematic review.
Patients diagnosed between 1978 and 2007 with thyroid metastases from renal cell carcinoma were retrospectively identified from the hospital database. A systematic literature search was performed for publications describing at least three cases of thyroid metastasis from renal cell carcinoma. Case data from the identified studies were collected and used to determine the survival data.
We identified 34 patients (19 females) from our hospital records with a mean age of 67 years (range, 33-79) when thyroid metastasis was diagnosed. Median time to primary metastasis after resection of renal cell carcinoma was 6.5 years (range, 0-25) with a single case of synchronous metastasis. Median survival after primary metastasis was 4.7 years (95% confidence interval [CI]: 1.8-7.6). The systematic review included 32 studies with 285 patients. Case data could be extracted for 202 patients. Median time to thyroid metastasis (without synchronous cases) was 8.8 years (95% CI: 7.5-10.1). Median actuarial survival after thyroid metastasis was 3.4 years (95% CI: 2.2-4.6). Total thyroidectomy was not associated with a better survival compared to partial thyroidectomies.
Time to thyroid metastasis of renal cell carcinoma can be very long, and survival after thyroidectomy is favorable compared to metastasis to other sites.
肾细胞癌可转移至不常见部位，例如甲状腺，甲状腺转移瘤很少见。为确定患者生存率以及癌症诊断与甲状腺转移之间的时间间隔，我们分析了来自本院记录的一大组患者，并进行了系统评价。
从医院数据库中回顾性识别出1978年至2007年间诊断为肾细胞癌甲状腺转移的患者。对描述至少3例肾细胞癌甲状腺转移病例的出版物进行系统文献检索。收集已识别研究的病例数据并用于确定生存数据。
我们从本院记录中识别出34例患者（19例女性），诊断甲状腺转移时的平均年龄为67岁（范围33 - 79岁）。肾细胞癌切除术后至首次转移的中位时间为6.5年（范围0 - 25年），有1例同步转移。首次转移后的中位生存期为4.7年（95%置信区间[CI]：1.8 - 7.6）。系统评价纳入了32项研究，共285例患者。可提取202例患者的病例数据。甲状腺转移（无同步病例）的中位时间为8.8年（95% CI：7.5 - 10.1）。甲状腺转移后的中位精算生存期为3.4年（95% CI：2.2 - 4.6）。与部分甲状腺切除术相比，全甲状腺切除术与更好的生存率无关。
肾细胞癌发生甲状腺转移的时间可能很长，与转移至其他部位相比，甲状腺切除术后的生存率较好。
