Thyroid Research Thyroid Research Archive Thyroid Cancer

Surgical resection of bone metastases may be beneficial in patients with thyroid cancer

(July 2002)

The background of the study. In some patients with thyroid cancer the cancer spreads to bone (bone metastases) at the time of diagnosis or later. This study evaluated the effect of surgical treatment of bone metastases.

How the study was done. The study subjects were 710 patients with papillary or follicular thyroid cancer treated by thyroidectomy at the Vienna University Hospital.

The results of the study. Bone metastases were found in 41 of the 710 patients (6 percent) at the time of diagnosis of thyroid cancer or during follow-up. In 15 patients (36 percent) pain caused by a bone metastasis was the initial symptom of thyroid cancer. The bone metastases were detected within 3 months after the diagnosis of thyroid cancer in 32 percent of patients, and 16 to 350 months after diagnosis in the other patients. Fifty-four percent had only bone metastases, and 46 percent had metastases to other organs (lungs, liver, or brain).

All the patients were treated by thyroidectomy, and 78 percent received radioiodine therapy. In 51 percent the bone metastases were surgically resected; other patients received radiotherapy or chemotherapy. The 5- and 10-year survival rates in the 41 patients from the time of diagnosis of thyroid carcinoma were 69 percent and 39 percent, respectively. Among the patients who had only bone metastases, surgery was associated with improved survival.

The conclusions of the study. Patients with thyroid cancer that has spread only to bone may benefit from surgical removal of the bone metastases.

The original article. Zettinig G, Fueger BJ, Passler C, Kaserer K, Pirich C, Dudczak R, Niederle B. Long-term follow-up of patients with bone metastases from differentiated thyroid carcinoma - surgery or conventional therapy? Clin Endocrinol 2002;56:377-82.