Management of Solitary Intracranial Metastases of Differentiated Thyroid Carcinoma: 11 Pathologically Confirmed Cases and Systematic Literature Review.

Management of Solitary Intracranial Metastases of Differentiated Thyroid Carcinoma: 11 Pathologically Confirmed Cases and Systematic Literature Review.

World Neurosurg. 2018 Jan 06;:

Authors: Chen M, Chen D, Xu J, Xu M, Zhong P

Abstract
BACKGROUND: Solitary intracranial metastases of differentiated thyroid carcinoma (DTC) are rare and the management is still controversial. This research is aim to seek for the suitable therapeutic methods of this disease.
METHODS: We retrospectively studied 11 pathologically confirmed cases of solitary intracranial metastases of DTC in a single institution from January 2000 to December 2016 and systematically reviewed 52 cases of this disease out of 416 cases presented in the literature on Pubmed. These 63 cases were analyzed by Kaplan-Meier (K-M), Cox regression analysis and post-hoc test.
RESULTS: The diameter of intracranial metastases of all 63 cases were greater than 2cm. Lung metastases (P=0.000) and neurosurgery (P=0.014) were two independent prognostic factors of this disease. Only neurosurgery (P=0.05) was an independent prognostic factor in the patients with lung metastases while neurosurgery (P=0.044) and whole brain radiotherapy (WBRT) (P=0.041) were two independent factors in the patients without lung metastases. Longer overall survival (OS) was achieved in gross total removal (GTR) and subtotal removal (STR) groups than no neurosurgery group (P=0.015, P=0.084, respectively), while there was no significance between GTR and STR groups (P=0.918).
CONCLUSIONS: The patients without lung metastases could achieve better prognosis than the patients with lung metastases. Neurosurgery could obviously improve the prognosis and if possible, GTR of metastases was supposed to achieve, otherwise, STR could be considered. WBRT was a suitable method after neurosurgery in the patients without lung metastases but could not prolong the OS in the patients with lung metastases.

PMID: 29317366 [PubMed - as supplied by publisher]

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