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The importance of age over radioiodine avidity as a prognostic factor in differentiated thyroid carcinoma with distant metastases
Thyroid, 03/19/09

Mihailovic J et al. - In a study to evaluate the influence of radioiodine uptake in distant metastases on the disease-specific survival (DSS) in differentiated thyroid carcinoma (DTC) pts, it was found that pts with distant metastases have a long-term survival that depends, in addition to other factors, on age and the degree of radioiodine uptake in distant metastases.

Methods

This study included 77 DTC pts with distant metastases (M1) who were treated with 131I therapy from 1977 to the end of 2000.
Median follow-up of pts was 6.1 yrs.
Univariate and multivariate analyses were performed using the Kaplan–Meier method and log rank test, and Cox Regression model, respectively.

Results

77 pts with M1 included 51 (66.2%) women and 26 (33.8%) men; 32 (41.6%) pts were <45 yrs old and 45 (58.4%) pts were ≥45 yrs old; histologically, there were 54 (70.1%) papillary carcinomas, 22 (28.6%) follicular carcinomas, and 1 case (1.3%) with an inconclusive histological report.
Probability of DSS after appearance of M1 was 57.95% after 5 yrs, 48.31% after 10 yrs, and 39.46% after 15 and 20 yrs.
In pts with iodine-avid distant metastases, 5-yr DSS was 66.54%, 10-yr DSS was 55.09%, and 15- and 20-year DSS were 44.99%.
Pts with non–iodine-avid lesions had a 5- and 10-yr DSS of 18.33%; the difference relating to the relationship between 131I uptake in distant metastases and survival was significant.
Proportion of pts with non–iodine-avid distant metastases that were ≥45 yrs old was significantly greater than the proportion with non–iodine-avid distant metastases that were <45 yrs old.
If pts were matched for age, iodine non-avidity significantly shortened survival in pts <45 years old.
Age had significantly greater influence on survival vs iodine avidity.

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