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Clinical Course from Diagnosis to Death in Patients with Well-Differentiated Thyroid Cancer

Because of the low mortality rate of well-differentiated thyroid cancer (WDTC), investigation of the clinical course leading to death is limited. We analyzed the cause of death and clinical course from diagnosis to death in patients who died of WDTC. A total of 592 WDTC patients died between 1996 an...

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Detalles Bibliográficos
Autores principales: Park, Hyunju, Park, Jun, Park, So Young, Kim, Tae Hyuk, Kim, Sun Wook, Chung, Jae Hoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7463440/
https://www.ncbi.nlm.nih.gov/pubmed/32824662
http://dx.doi.org/10.3390/cancers12082323
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author Park, Hyunju
Park, Jun
Park, So Young
Kim, Tae Hyuk
Kim, Sun Wook
Chung, Jae Hoon
author_facet Park, Hyunju
Park, Jun
Park, So Young
Kim, Tae Hyuk
Kim, Sun Wook
Chung, Jae Hoon
author_sort Park, Hyunju
collection PubMed
description Because of the low mortality rate of well-differentiated thyroid cancer (WDTC), investigation of the clinical course leading to death is limited. We analyzed the cause of death and clinical course from diagnosis to death in patients who died of WDTC. A total of 592 WDTC patients died between 1996 and 2018. After exclusion, 79 patients were enrolled and divided into four groups based on their clinical course; that is, inoperable at the time of diagnosis (inoperable), distant metastasis (DM) detected at the time of diagnosis (initial-DM), DM detected during follow-up (late-DM), and loco-regional disease (L-R). Lung (55.6%) in papillary thyroid carcinoma (PTC) and bone (46.7%) in follicular thyroid carcinoma (FTC) were the most common metastasis locations. The most common causes of death were respiratory failure (32.3%) and airway obstruction (30.6%) in PTC, and complications due to immobilization arising from bone metastasis (35.3%) in FTC. Brain metastasis was found in 13.3% of patients and had the worst prognosis. The overall survival (OS) differed significantly (p = 0.001) according to clinical course; the inoperable had the shortest survival, followed by the initial-DM, L-R, and late-DM. However, OS did not differ significantly between PTC and FTC patients with initial-DM (p = 0.83). Other causes of death were far more common than death resulting from WDTC. In patients dying of WDTC, the major cause of death varied by metastatic site. OS differed according to clinical course, but not histologic type. Timing and DM sites differed between PTC and FTC.
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spelling pubmed-74634402020-09-04 Clinical Course from Diagnosis to Death in Patients with Well-Differentiated Thyroid Cancer Park, Hyunju Park, Jun Park, So Young Kim, Tae Hyuk Kim, Sun Wook Chung, Jae Hoon Cancers (Basel) Article Because of the low mortality rate of well-differentiated thyroid cancer (WDTC), investigation of the clinical course leading to death is limited. We analyzed the cause of death and clinical course from diagnosis to death in patients who died of WDTC. A total of 592 WDTC patients died between 1996 and 2018. After exclusion, 79 patients were enrolled and divided into four groups based on their clinical course; that is, inoperable at the time of diagnosis (inoperable), distant metastasis (DM) detected at the time of diagnosis (initial-DM), DM detected during follow-up (late-DM), and loco-regional disease (L-R). Lung (55.6%) in papillary thyroid carcinoma (PTC) and bone (46.7%) in follicular thyroid carcinoma (FTC) were the most common metastasis locations. The most common causes of death were respiratory failure (32.3%) and airway obstruction (30.6%) in PTC, and complications due to immobilization arising from bone metastasis (35.3%) in FTC. Brain metastasis was found in 13.3% of patients and had the worst prognosis. The overall survival (OS) differed significantly (p = 0.001) according to clinical course; the inoperable had the shortest survival, followed by the initial-DM, L-R, and late-DM. However, OS did not differ significantly between PTC and FTC patients with initial-DM (p = 0.83). Other causes of death were far more common than death resulting from WDTC. In patients dying of WDTC, the major cause of death varied by metastatic site. OS differed according to clinical course, but not histologic type. Timing and DM sites differed between PTC and FTC. MDPI 2020-08-18 /pmc/articles/PMC7463440/ /pubmed/32824662 http://dx.doi.org/10.3390/cancers12082323 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Park, Hyunju
Park, Jun
Park, So Young
Kim, Tae Hyuk
Kim, Sun Wook
Chung, Jae Hoon
Clinical Course from Diagnosis to Death in Patients with Well-Differentiated Thyroid Cancer
title Clinical Course from Diagnosis to Death in Patients with Well-Differentiated Thyroid Cancer
title_full Clinical Course from Diagnosis to Death in Patients with Well-Differentiated Thyroid Cancer
title_fullStr Clinical Course from Diagnosis to Death in Patients with Well-Differentiated Thyroid Cancer
title_full_unstemmed Clinical Course from Diagnosis to Death in Patients with Well-Differentiated Thyroid Cancer
title_short Clinical Course from Diagnosis to Death in Patients with Well-Differentiated Thyroid Cancer
title_sort clinical course from diagnosis to death in patients with well-differentiated thyroid cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7463440/
https://www.ncbi.nlm.nih.gov/pubmed/32824662
http://dx.doi.org/10.3390/cancers12082323
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