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See Latest ArticlesThoracic metastasectomy for thyroid malignancies
European Journal of Cardio-Thoracic Surgery, 07/07/09
Porterfield JR et al. - In a study to better define early and long-term outcomes of pts undergoing thoracic metastasectomy for thyroid cancer, pulmonary resection for thyroid metastasis is safe with low morbidity and mortality. Retrospective analysis demonstrates improved long-term survival in pts with papillary histology, longer disease-free interval and younger age at diagnosis of initial thyroid malignancy.
Methods- Medical records of all pts who underwent thoracic metastasectomy for thyroid cancer were identified, reviewed, and analyzed.
- There were 48 pts (25 men, 23 women).
- Complete resection (R0) of all known disease was performed in 33 (69%) pts, while 15 (31%) underwent incomplete resection (R1 or R2).
- By histology, the majority were papillary 31 (65%), follicular 8 (17%), medullary 5 (10%), and Hürthle cell 4 (8%).
- 90% were confined to a single side of the chest, with 10% presenting with bilateral metastases.
- Thoracotomy was performed in 28 (58%), sternotomy in 12 (25%), and thoracoscopy in 8 (17%).
- Operative mortality was 0 and postoperative complications occurred in 8 pts (17%).
- There are currently 18 surviving pts (37%) with median follow-up of 10 yrs.
- Overall 5-yr survival after thoracic metastasectomy was 60%.
- Based on histology, 5-yr survival for papillary cancer was 64% vs 37% for follicular and Hürthle cell neoplasms.
- All 5 medullary thyroid cancer pts were alive at 5 yrs.
- 5-yr survival was improved for pts <45 yrs old at time of diagnosis of their initial thyroid malignancy (94% vs 49%).
- Disease-free interval of >3 yrs between initial thyroid malignancy diagnosis and thoracic metastasectomy demonstrated improved 5-yr survival (67% vs 52%).
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