Dan Jiaqiang, Tan Jingya, Guo Yao, Lu Xin, Leng Ying, Tang Renxi, Li Junyan, Huang Junhua
Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Department of Thyroid and Breast Surgery, Chengdu Fifth People's Hospital (The Second Clincal Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), NO. 33 Ma Shi Street,Wenjiang District, Chengdu, 611130, China.
Department of Rheumatology and Immunology, Wenjiang Dstrict People's Hospital of Chengdu City, NO. 86 Kangtai Road, Wenjiang District, Chengdu, 611130, China.
Sci Rep. 2025 Jul 1;15(1):21932. doi: 10.1038/s41598-025-08845-y.
Metastatic differentiated thyroid cancer (mDTC) can exhibit aggressive growth and disseminate to distant organs, thereby reducing survival rates. The benefits of primary tumor resection (PTR) for patients with mDTC are still debated. In this study, we utilized the Surveillance, Epidemiology, and End Results (SEER) database to evaluate mDTC patients, focusing on the impact of organ-specific metastases and the number of metastatic sites on prognosis, as well as the potential efficacy of PTR as a therapeutic intervention. 904 patients with mDTC at initial diagnosis from 2010 to 2015 were studied. Lung and bone were the most common sites of metastasis. Patients with brain, lung and liver metastasis had significantly worse overall survival (OS) (all p < 0.05) and cancer-specific survival (CSS) (all p < 0.05). Among all the patients, 550 (60.84%) underwent PTR, which was associated with reduced risk of overall mortality (OM) and cancer-specific mortality (CSM) (all p < 0.05). When analyzing different metastatic patterns, PTR significantly lowered the risk of OM and CSM for patients with bone, brain, lung, liver, or distant lymph node (DLN) involvement (all p < 0.05). Surgical resection also improved OS and CSS (both p < 0.05) in patients with multiple organ involvement or one/two metastases. Our findings suggest that PTR may confer benefits to select individuals with metastatic DTC. To validate these results and facilitate their integration into clinical practice, multicenter prospective studies are warranted.
转移性分化型甲状腺癌（mDTC）可呈现侵袭性生长并扩散至远处器官，从而降低生存率。对于mDTC患者，原发肿瘤切除（PTR）的益处仍存在争议。在本研究中，我们利用监测、流行病学和最终结果（SEER）数据库评估mDTC患者，重点关注器官特异性转移和转移部位数量对预后的影响，以及PTR作为一种治疗干预措施的潜在疗效。研究了2010年至2015年初次诊断为mDTC的904例患者。肺和骨是最常见的转移部位。发生脑、肺和肝转移的患者总生存期（OS）（均p＜0.05）和癌症特异性生存期（CSS）（均p＜0.05）明显更差。在所有患者中，550例（60.84%）接受了PTR，这与总死亡率（OM）和癌症特异性死亡率（CSM）风险降低相关（均p＜0.05）。在分析不同转移模式时，PTR显著降低了骨、脑、肺、肝或远处淋巴结（DLN）受累患者的OM和CSM风险（均p＜0.05）。手术切除也改善了多器官受累或有一处/两处转移患者的OS和CSS（均p＜0.05）。我们的研究结果表明，PTR可能对部分转移性DTC患者有益。为了验证这些结果并促进其纳入临床实践，有必要开展多中心前瞻性研究。
