AUTHOR=Liu Xiajun , Hu Panpan , Zhai Shuheng , Liu Xiao , Wang Ben , Zhou Hua , Liu Xiaoguang , Liu Zhongjun , Wei Feng 

TITLE=Surgery for metastatic spinal differentiated thyroid cancer: feasibility, outcome, and prognostic factors

JOURNAL=Frontiers in Surgery

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2023.1140150

DOI=10.3389/fsurg.2023.1140150

ISSN=2296-875X

ABSTRACT=<sec><title>Study design</title><p>A retrospective cohort study.</p></sec><sec><title>Objectives</title><p>This study aims to report the surgical outcome of metastatic spinal differentiated thyroid cancer (MSDTC) and analyze the factors affecting the prognosis.</p></sec><sec><title>Methods</title><p>Thirty-five patients were recruited in our single institution who underwent spinal surgery and adjuvant therapies from 2009 to 2019. Two surgical procedures, total <italic>en-bloc</italic> spondylectomy and debulking surgery, were undertaken. Their clinical data, postoperative events, and survival data were collected and analyzed. Survival time and associated factors were further analyzed.</p></sec><sec><title>Results</title><p>The cohort had a median survival time of 60 months. The mean visual analog scale scores and the Karnofsky performance score improved postoperatively (<italic>p</italic> &lt; 0.05). The patients' Frankel grade was elevated for cases with preoperative neurological deficits (<italic>p</italic> &lt; 0.05). In 31 patients who underwent debulking surgery, 41.9% (<italic>n</italic> = 13) had local recurrences, and radiotherapy reduced the risk of local relapse (<italic>p</italic> &lt; 0.05). Preoperative and postoperative Frankel grades and radioactive iodine (RAI) therapy were associated with the patients’ survival in the univariate analysis (<italic>p</italic> &lt; 0.05). Furthermore, a multivariate regression analysis showed the postoperative Frankel grade as an independent prognostic factor.</p></sec><sec><title>Conclusion</title><p>Pain, quality of life, and neurological status of patients can be effectively improved after surgery. Radiotherapy can reduce the risk of local recurrences, whereas RAI therapy has a limited effect on local and extraspinal tumor control. Neurological status was independently associated with the patients' survival.</p></sec>