Well differentiated thyroid cancer is one of
the least morbid solid malignancies, with
favorable long term survival. However,
presence of distant metastases at time of
initial evaluation (synchronous metastases,
SM) is a strong predictor of poor outcome, as
43-90% of those patients die from their
thyroid malignancy. The aim of the current
study is to detect significant prognostic
factors that can affect patient outcome and
disease specific survival in patients with well
differentiated thyroid cancer associated with
SM. Patients and methods: retrospective
analysis of data from patients with
pathologically proven well differentiated
thyroid cancer having established SM was
done. All patients were presented to three
oncology centers in the period from Jan. 1992
to Jan 2007. 101 patients were included in the
current study, they were followed up for a
mean period of 60months, evaluating the
effects of different factors on patient outcome
and survival. Results: It was found that age,
size and extent of metastases and their ability
to accumulate I131 had positive impact on
patient outcome and survival .Young patients
with few small metastatic lesions that have
the ability to accumulate radioactive iodine
(I131) have significantly better outcome and
survival compared to those older than 45
years, with multiple big metastases that do
not accumulate I131.
On the other hand, gender, type of
histopathology, local recurrence, the site of
metastases and serum thyroglobulin(Tg) level
have no statistical significant difference on
patient outcome and survival.
Conclusion: In patients with well
differentiated thyroid cancer associated with
SM the most important factors that have
significant impact on patient outcome and do
affect survival are age, size, extent of
metastatic lesions, as well as, their ability to
accumulate I131 . The most favorable
outcome is for patients younger than 45 years
with few small SM that accumulate I131.