Long-term outcomes and prognostic factors of patients with lung metastases from differentiated thyroid cancer after radioiodine therapy in Japan

Long-term survival in patients with differentiated thyroid cancer (DTC) and lung metastasis remains unexplored in Japan. This study aimed to investigate the long-term survival and prognostic factors of radioiodine therapy (RIT) in a University Hospital setting. This retrospective study included 62 p...

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Bibliographic Details
Published in:Endocrine Journal 2023, Vol.70(3), pp.315-322
Main Authors: Akatani, Norihito, Wakabayashi, Hiroshi, Kayano, Daiki, Inaki, Anri, Takata, Aki, Hiromasa, Tomo, Yamase, Takafumi, Kunita, Yuji, Watanabe, Satoru, Mori, Hiroshi, Saito, Shintaro, Nakajima, Kenichi, Kinuya, Seigo
Format: Article
Language:English
Subjects:
Adenocarcinoma
Computed tomography
Differentiated thyroid cancer
Humans
Iodine Radioisotopes - therapeutic use
Japan - epidemiology
Lung cancer
Lung metastasis
Lung Neoplasms - radiotherapy
Lung Neoplasms - secondary
Lung nodules
Medical prognosis
Metastases
Metastasis
Overall survival
Prognosis
Prognostic factor
Radioiodine therapy
Retrospective Studies
Survival
Thyroglobulin
Thyroid cancer
Thyroid Neoplasms - pathology
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Summary:Long-term survival in patients with differentiated thyroid cancer (DTC) and lung metastasis remains unexplored in Japan. This study aimed to investigate the long-term survival and prognostic factors of radioiodine therapy (RIT) in a University Hospital setting. This retrospective study included 62 patients with lung metastases from DTC who received RIT between March 2005 and December 2016. According to the 131I whole-body scan and chest computed tomography results, lung metastases were classified as 131I-avid or non-131I-avid, and miliary, micronodular, or macronodular metastases. The 5- and 10-year overall survival (OS) rates from the initial RIT were calculated by the Kaplan–Meier method, and a proportional hazard fit analysis was performed to determine prognostic factors. With a median follow-up of 7.9 years, the 5- and 10-year OS rates from the initial RIT were 93% and 72%, respectively. Univariable and multivariable analyses of patient subgroups revealed that macronodular lung metastases (defined as nodules >1 cm), older age at initial RIT, and high thyroglobulin values (>400 ng/mL) at initial RIT predicted low OS. The 5- and 10-year OS rates of DTC patients with lung metastases were similar to those in previous Japanese reports, which included a smaller sample size compared with ours. Patients with ≤1 cm lung metastases, aged ≤55 years, and a thyroglobulin level of ≤400 ng/mL at the initial RIT had favorable outcomes.
ISSN:0918-8959
1348-4540
DOI:10.1507/endocrj.EJ22-0463