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©The Author(s) 2025.
World J Clin Cases. Sep 6, 2025; 13(25): 105204
Published online Sep 6, 2025. doi: 10.12998/wjcc.v13.i25.105204
Published online Sep 6, 2025. doi: 10.12998/wjcc.v13.i25.105204
Table 1 Characteristics of 39 poorly differentiated thyroid carcinoma patients, n (%)
| M0 (n = 18) | M1 (n = 16) | M2 (n = 5) | P value |
Age, median (years, IQR) | 41 (26-59) | 52 (49-63) | 58 (51-62) | 0.042 |
Age | 0.060 | |||
< 45 years | 10 (55.6) | 3 (18.8) | 1 (20.0) | |
≥ 45 years | 8 (44.4) | 13 (81.2) | 4 (80.0) | |
Sex | 0.045 | |||
Female | 13 (72.2) | 7 (43.8) | 5 (100) | |
Male | 5 (27.8) | 9 (56.2) | 0 | |
Tumor size (cm) | 0.222 | |||
≤ 2 | 3 (16.7) | 0 | 0 | |
> 2-4 | 6 (33.3) | 6 (37.5) | 3 (75.0) | |
> 4 | 9 (50.0) | 10 (62.5) | 1 (25.0) | |
T stage | 0.536 | |||
T1 | 3 (16.7) | 0 | 0 | |
T2 | 4 (22.2) | 5 (31.2) | 1 (20.0) | |
T3 | 5 (27.8) | 3 (18.8) | 1 (20.0) | |
T4 | 6 (33.3) | 8 (50.0) | 3 (60.0) | |
N stage | 0.323 | |||
N0 | 17 (94.4) | 13 (81.2) | 5 (100) | |
N1 | 4 (10.3) | 3 (18.8) | 0 | |
Extrathyroidal invasion | 6 (33.3) | 8 (50.0) | 4 (80.0) | 0.166 |
Initial metastatic sites | ||||
Lung | 0 | 9 (56.3) | 3 (60.0) | |
Bone | 0 | 3 (18.8) | 0 | |
Lung, bone | 0 | 2 (12.5) | 2 (40.0) | |
Lung, brain | 0 | 1 (6.3) | 0 | |
Bone, brain | 0 | 1 (6.3) | 0 | |
Type of thyroid surgery | 0.041 | |||
Lobectomy or subtotal thyroidectomy | 0 | 4 (25.0) | 0 | |
Total thyroidectomy | 18 (100) | 12 (75.0) | 5 (100) | |
131I therapy | 11 (61.1) | 12 (75.0) | 5 (100) | 0.217 |
131I cumulative dose, median (mCi, IQR) | 75 (15-100) | 100 (97-162) | 580 (100-835) | 0.005 |
External beam radiation therapy | 3 (16.7) | 7 (43.8) | 3 (60.0) | 0.099 |
External beam radiation therapy, median (cGy, IQR) | 5600 (3950-6200) | 3720 (1725-5310) | 5000 (4750-5500) | 0.634 |
Targeted therapy | 0 | 3 (18.8) | 1 (20.0) | - |
Lenvatinib | 0 | 1 (6.25) | 0 | |
Lenvatinib, sorafenib | 0 | 2 (12.5) | 0 | |
Lenvatinib, sorafenib, cabozantinib | 0 | 0 | 1 (20.0) | |
Cancer-specific mortality | 1 (5.6) | 10 (62.5) | 5 (100) | 0.001 |
Overall mortality | 2 (11.1) | 12 (75.0) | 5 (100) | 0.001 |
Follow-up, median (years, IQR) | 8.0 (2.4-14.3) | 2.0 (1.4-5.2) | 4.2 (2.8-8.1) | 0.156 |
Table 2 Risk factors associated with cancer-specific mortality in poorly differentiated thyroid carcinoma patients, n (%)
| Survival (n = 23) | Mortality (n = 16) | Univariate HR (95%CI) | P value | Multivariate HR (95%CI)1 | P value |
Age | ||||||
< 45 years | 11 (47.8) | 3 (18.8) | Reference | |||
≥ 45 years | 12 (52.2) | 13 (81.2) | 3.47 (0.95–12.6) | 0.060 | ||
Sex | ||||||
Female | 14 (60.9) | 11 (68.8) | Reference | |||
Male | 9 (39.1) | 5 (31.2) | 1.58 (0.52–4.81) | 0.416 | ||
Tumor size | ||||||
≤ 2 cm | 3 (13.0) | 0 | Reference | |||
> 2-4 cm | 7 (30.4) | 8 (53.3) | ||||
> 4 cm | 13 (56.5) | 7 (46.7) | 1.39 (0.62–3.12) | 0.423 | ||
T stage | ||||||
T1/T2 | 8 (34.8) | 5 (31.2) | Reference | |||
T3/T4 | 15 (65.2) | 11 (68.8) | 1.31 (0.44–3.85) | 0.627 | ||
N stage | ||||||
N0 | 23 (100) | 12 (75.0) | Reference | Reference | ||
N1 | 0 | 4 (25.0) | 6.86 (1.82–25.8) | 0.004 | 10.1 (2.34–43.3) | 0.002 |
M stage | ||||||
M0 | 17 (73.9) | 1 (37.5) | Reference | Reference | ||
M1 | 6 (26.1) | 10 (62.5) | ||||
M2 | 0 | 5 (31.2) | 2.96 (1.53–5.74) | 0.001 | 2.41 (1.07–5.39) | 0.033 |
Extrathyroidal invasion | ||||||
No | 14 (60.9) | 7 (43.8) | Reference | |||
Yes | 9 (39.1) | 9 (56.2) | 1.64 (0.61–4.43) | 0.329 | ||
Type of thyroid surgery | ||||||
Total thyroidectomy | 21 (91.3) | 14 (87.5) | Reference | |||
Lobectomy or subtotal thyroidectomy | 2 (4.3) | 2 (6.2) | 3.48 (0.71–17.0) | 0.124 | ||
131I cumulative dose | ||||||
< 100 mCi | 14 (60.9) | 7 (43.8) | Reference | |||
≥ 100 mCi | 9 (39.1) | 9 (56.2) | 1.42 (0.52–3.83) | 0.493 | ||
External beam radiation therapy | ||||||
No | 20 (87.0) | 6 (37.5) | Reference | Reference | ||
Yes | 3 (13.0) | 10 (62.5) | 4.42 (1.50–13.0) | 0.007 | 3.07 (0.86–11.0) | 0.084 |
Table 3 Clinical features of five patients who developed metastatic disease during follow-up
Patient number | Age/Sex | TNM at diagnosis | Type of thyroid surgery | Time from PDTC diagnosis to metastasis (years) | Cumulative dose of RAI before metastasis (mCi) | Positive finding at detection | Sites of metastasis | Time from metastasis to death (years) | Cumulative dose of RAI (mCi) | External beam radiation therapy, dose (cGy) | Targeted therapy |
1 | 44/F | T4N0M0 | Total thyroidectomy | 11.9 | 0 | CT | Lung, bone | 5.9 | 980 | 6000 | |
2 | 51/F | T4N0M0 | Total thyroidectomy | 1.7 | 100 | PET/CT | Lung | 2.5 | 100 | 0 | Lenvatinib, sorafenib, cabozantinib |
3 | 58/F | T4N0M0 | Total thyroidectomy | 0.7 | 30 | RAI scan | Lung | 2.1 | 580 | 5000 | |
4 | 62/F | T2N0M0 | Total thyroidectomy | 4.9 | 160 | Chest X-ray | Lung, bone | 3.2 | 835 | 4500 | |
5 | 77/F | T3N0M0 | Total thyroidectomy | 0.9 | 30 | Chest X-ray | Lung | 0.6 | 60 | 0 |
Table 4 Risk factors associated with distant metastasis in poorly differentiated thyroid carcinoma patients, n (%)
M0 (n = 18) | M1 + M2 (n = 21) | Univariate OR (95%CI) | P value | |
Age | ||||
< 45 years | 10 (55.6) | 4 ((19.0) | Reference | |
≥ 45 years | 8 (44.4) | 17 (81.0) | 5.31 (1.27–22.2) | 0.018 |
Sex | ||||
Female | 13 (72.2) | 12 (57.1) | Reference | |
Male | 5 (27.8) | 9 (42.9) | 1.95 (0.51–7.49) | 0.328 |
Tumor size | ||||
≤ 2 cm | 3 (16.7) | 0 | Reference | |
> 2-4 cm | 6 (33.3) | 9 (45.0) | ||
> 4 cm | 9 (50.0) | 11 (55.0) | 1.72 (0.62–4.83) | 0.301 |
T stage | ||||
T1/T2 | 7 (38.9) | 6 (28.6) | Reference | |
T3/T4 | 11 (61.1) | 15 (71.4) | 1.59 (0.42–6.07) | 0.496 |
N stage | ||||
N0 | 17 (94.4) | 18 (85.7) | Reference | |
N1 | 1 (5.6) | 3 (14.3) | 2.83 (0.27–29.9) | 0.370 |
- Citation: Hsu CW, Hsueh C, Lu YL, Hsu CJ, Wong RJ, Lin SF. Risk factors and outcomes of metastatic poorly differentiated thyroid carcinoma. World J Clin Cases 2025; 13(25): 105204
- URL: https://www.wjgnet.com/2307-8960/full/v13/i25/105204.htm
- DOI: https://dx.doi.org/10.12998/wjcc.v13.i25.105204