Zhong Miaochun, Khan Farhana Zerin, He Xianghong, Cui Lingfei, Lei Kefeng, Ge Minghua
Department of Clinical Medicine, Medical College of Soochow University, Suzhou 215006, China.
Department of General Surgery, Cancer Center, Division of Breast Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310014, China.
Cancers (Basel). 2022 Jun 26;14(13):3133. doi: 10.3390/cancers14133133.
We investigate the impact of lung metastasis versus metastasis of bone, brain, or liver on overall survival (OS) and thyroid cancer-specific survival (TCSS) in patients with thyroid cancer (TC). Therefore, de-identified SEER 18 registry data of primary TC patients diagnosed between 2010 and 2016 were analyzed. The primary outcome was the prognosis of TC patients with lung metastasis compared with other sites. The secondary outcomes included the prognosis comparison between patients with and without surgery and between single and multiple metastasis sites. Isolated lung metastasis was associated with worse OS and TCSS than bone metastasis (both p < 0.05) and was associated with worse OS than liver metastasis (p = 0.0467). Surgery performed either for the primary or distant site was associated with better OS and TCSS in patients with metastasis of lung or bone (p < 0.05). Isolated lung metastasis was related to better OS and TCSS than lung−liver, lung−brain, and lung−other multiple metastases. The multivariable analysis revealed that age < 55 years, surgery to the primary site, and to the distant site(s) were associated with better outcomes, while T4 and Tx were associated with worse outcomes. Nevertheless, it revealed that the other race (i.e., any race other than white, black, or unknown) and male gender were associated with better TCSS only (p < 0.05). Isolated lung metastasis is associated with a worse prognosis in TC patients compared with bone or liver metastasis. Surgery performed either for the primary or distant site(s) is associated with better survival outcomes in TC patients with metastasis of lung or bone.
我们研究了甲状腺癌（TC）患者中肺转移与骨、脑或肝转移对总生存期（OS）和甲状腺癌特异性生存期（TCSS）的影响。因此，我们分析了2010年至2016年间确诊的原发性TC患者的去识别化SEER 18登记数据。主要结局是与其他部位相比，发生肺转移的TC患者的预后。次要结局包括有手术和无手术患者之间以及单转移部位和多转移部位患者之间的预后比较。与骨转移相比，孤立性肺转移与更差的OS和TCSS相关（均p<0.05），且与肝转移相比，OS更差（p = 0.0467）。对于肺或骨转移患者，针对原发灶或远处转移灶进行的手术与更好的OS和TCSS相关（p<0.05）。与肺-肝、肺-脑和肺-其他多转移相比，孤立性肺转移与更好的OS和TCSS相关。多变量分析显示，年龄<55岁、对原发灶和远处转移灶进行手术与更好的结局相关，而T4和Tx与更差的结局相关。然而，分析显示其他种族（即除白人黑人或未知种族以外的任何种族）和男性仅与更好的TCSS相关（p<0.05）。与骨或肝转移相比，孤立性肺转移与TC患者更差的预后相关。对于肺或骨转移的TC患者，针对原发灶或远处转移灶进行的手术与更好的生存结局相关。
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