Aziz Abdul, Khan Sajjad Ali, Suchal Zafar A, Islam Najmul
Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.
Indian J Endocrinol Metab. 2022 Mar-Apr;26(2):137-140. doi: 10.4103/ijem.ijem_455_21. Epub 2022 Jun 6.
Differentiated thyroid carcinoma (DTC) is a slow-growing tumour with 20% of the cases having distant metastasis. Its prognosis can vary by its histological characteristics, extension and spread. The data on metastatic DTC patients in Pakistan is scarce; therefore, the purpose of our study was to assess the clinicopathological characteristics and treatment outcomes of metastatic DTC in our population.
This retrospective, single-centre study was carried out on 117 patients with metastatic DTC with their age at diagnosis, gender, tumour size and extent and spread of the tumour, and its histologic characteristic recorded. The treatment they received and the outcome in terms of status, at last, follow-up were also recorded.
The mean age of diagnosis was found to be 46.6 ± 17.2 years with an almost equal male to female ratio. The most common site of metastasis was the lung followed by bone. Papillary carcinoma was the most common subtype with 89.7% of the cases followed by follicular carcinoma occurring in 7.7%. The overall survival in years was found to be 5.6 ± 2.6 years. Ninety-six per cent had complete surgical resection followed by radioactive iodine (RAI) in 91.5%.
Our study shows that the most significant factors in predicting the outcome in metastatic DTC are age, an extrathyroidal extension of the primary tumour and distant metastasis. However, further multicentric studies done on a much larger population will be needed to further support and strengthen our results.
分化型甲状腺癌(DTC)是一种生长缓慢的肿瘤,20%的病例会发生远处转移。其预后因组织学特征、范围及扩散情况而异。巴基斯坦关于转移性DTC患者的数据匮乏;因此,我们研究的目的是评估我国人群中转移性DTC的临床病理特征及治疗结果。
本项回顾性单中心研究针对117例转移性DTC患者开展,记录了他们的诊断年龄、性别、肿瘤大小、肿瘤范围及扩散情况,以及组织学特征。还记录了他们接受的治疗以及最后随访时的状态结局。
发现诊断时的平均年龄为46.6±17.2岁,男女比例几乎相等。最常见的转移部位是肺,其次是骨。乳头状癌是最常见的亚型,占病例的89.7%,其次是滤泡状癌,占7.7%。发现总体生存年限为5.6±2.6年。96%的患者接受了完整的手术切除,91.5%的患者随后接受了放射性碘(RAI)治疗。
我们的研究表明,预测转移性DTC预后的最重要因素是年龄、原发肿瘤的甲状腺外扩展及远处转移。然而,需要在更大规模人群上开展进一步的多中心研究,以进一步支持和强化我们的结果。