Patients with differentiated
thyroid carcinomas (DTCs) have a favourable long-term survival. Spinal
metastases (SMs) cause a decline in performance status (PS), directly affecting mortality and indirectly preventing the use of systemic
therapies.
Metastasectomy is indicated, if feasible, as it yields the best local tumour control. Our study aimed to examine the long-term clinical outcomes of
metastasectomy for SMs of
thyroid carcinomas. We collected data on 22 patients with DTC (16 follicular and six
papillary carcinomas) and one patient with
medullary carcinoma who underwent complete surgical resection of SMs at our institution between July 1992 and July 2017, with a minimum postoperative follow-up of five years. The
cancer-specific survival (CSS) from the first spinal
metastasectomy to death or the last follow-up was determined using Kaplan-Meier analysis. Potential factors associated with survival were evaluated using the log-rank test. We analyzed the clinical parameters and outcome data, including pre- and postoperative disability (Eastern Cooperative Oncology Group PS 3), lung and non-spinal bone
metastases, and history of radioiodine and
kinase inhibitor
therapies. Lung and other bone
metastases at the time of surgery were observed in ten and eight patients, respectively. Three patients experienced local tumour recurrences at the operated site. The five- and ten-year CSS rates in the 22 patients with DTC were 77% and 52%, respectively. Pre- and postoperative disability and operative site tumour recurrence were identified as risk factors for short postoperative survival.
Metastasectomy for resectable SM from DTC yielded favourable results and has the potential to improve survival.