Adrenal metastases of differentiated thyroid cancer: clinicopathological characteristics and prognostic factors
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
Purpose To investigate the impact of adrenal metastases (AM) of differentiated thyroid cancer (DTC) through the comparison of clinicopathological characteristics and prognoses between DTC patients with AM and those with other distant metastatic sites. Methods We retrospectively analyzed the records of 84 DTC patients (28 DTC patients with AM and 56 with other metastatic sites) who underwent surgery andI therapy based on a review of the Shanghai Sixth People’s Hospital medical records from September 2014 to January 2025. Univariate analysis with the log-rank test was performed to evaluate survival outcomes and prognostic factors of overall survival (OS), while parameters with a P-value < 0.05 were further subjected to multivariate analysis using the Cox proportional hazards model. Results A total of 84 patients with DTC were enrolled in this study, among whom 28 were diagnosed with AM and 56 with distant metastases at other sites. All patients in both groups received radioactive iodine therapy. The proportion of radioactive iodine-refractory DTC (RAIR-DTC) was significantly higher in the DTC with AM (DTC-AM) group (71.43% vs. 44.64%). The median time of follow-up of the DTC patients with AM and those without was 29.6 months (5.0-112.5 months) and 69.3 months (10.4-146.7 months), respectively. At the end of follow-up, 10 patients (35.71%) died in the DTC-AM group, while 8 patients (14.29%) died in the non-DTC-AM group. The 5- and 10-year OS rates of the DTC-AM group were 65.31%
Abstract
Purpose To investigate the impact of adrenal metastases (AM) of differentiated thyroid cancer (DTC) through the comparison of clinicopathological characteristics and prognoses between DTC patients with AM and those with other distant metastatic sites. Methods We retrospectively analyzed the records of 84 DTC patients (28 DTC patients with AM and 56 with other metastatic sites) who underwent surgery andI therapy based on a review of the Shanghai Sixth People’s Hospital medical records from September 2014 to January 2025. Univariate analysis with the log-rank test was performed to evaluate survival outcomes and prognostic factors of overall survival (OS), while parameters with a P-value < 0.05 were further subjected to multivariate analysis using the Cox proportional hazards model. Results A total of 84 patients with DTC were enrolled in this study, among whom 28 were diagnosed with AM and 56 with distant metastases at other sites. All patients in both groups received radioactive iodine therapy. The proportion of radioactive iodine-refractory DTC (RAIR-DTC) was significantly higher in the DTC with AM (DTC-AM) group (71.43% vs. 44.64%). The median time of follow-up of the DTC patients with AM and those without was 29.6 months (5.0-112.5 months) and 69.3 months (10.4-146.7 months), respectively. At the end of follow-up, 10 patients (35.71%) died in the DTC-AM group, while 8 patients (14.29%) died in the non-DTC-AM group. The 5- and 10-year OS rates of the DTC-AM group were 65.31% and 46.65% versus 92.88% and 78.23% in the non-DTC-AM group. The presence of AM, advanced age at diagnosis of distant metastases (≥60y) and large maximal primary tumor size (≥4cm) were independently associated with poor survival (all P<0.05). Conclusion Patients with DTC-AM are characterized by a higher proportion of advanced age at diagnosis of distant metastases, larger primary tumor size, a predominance of multiple synchronous distant metastatic sites, a higher rate of RAIR-DTC, and more frequent use of tyrosine kinase inhibitor therapy. AM exerted a significant negative impact on the prognoses of DTC patients. The occurrence of AM, advanced age at diagnosis of distant metastases (≥60y) and large maximal primary tumor size (≥4cm) were independent risk factors for unfavorable prognoses of DTC patients with distant metastases.