Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 90-101 |
| Number of pages | 12 |
| Journal | Endocrine |
| Volume | 59 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2018 |
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Real-life management and outcome of thyroid carcinoma-related bone metastases: results from a nationwide multicenter experience. / Mazziotti, Gherardo; Formenti, AM; Panarotto, MB; Arvat, E; Chiti, A; Cuocolo, A; Dottorini, ME; Durante, C; Agate, L; Filetti, S; Felicetti, F; Filice, A; Pace, L; Pellegrino, T; Rodari, M; Salvatori, M; Tranfaglia, C; Versari, A; Viola, D; Frara, S; Berruti, A; Giustina, A; Giubbini, R.
In: Endocrine, Vol. 59, No. 1, 2018, p. 90-101.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Real-life management and outcome of thyroid carcinoma-related bone metastases: results from a nationwide multicenter experience
AU - Mazziotti, Gherardo
AU - Formenti, AM
AU - Panarotto, MB
AU - Arvat, E
AU - Chiti, A
AU - Cuocolo, A
AU - Dottorini, ME
AU - Durante, C
AU - Agate, L
AU - Filetti, S
AU - Felicetti, F
AU - Filice, A
AU - Pace, L
AU - Pellegrino, T
AU - Rodari, M
AU - Salvatori, M
AU - Tranfaglia, C
AU - Versari, A
AU - Viola, D
AU - Frara, S
AU - Berruti, A
AU - Giustina, A
AU - Giubbini, R
PY - 2018
Y1 - 2018
N2 - Purpose and Patients: The M.O.S.CA.TI. (Metastases of the Skeleton from CArcinoma of the ThyroId) is a multicenter, retrospective study investigating the real-life outcome and management of bone metastases (BM) in 143 patients (63 M, 80 F; median age 64 years, range 11–87) with differentiated thyroid carcinoma (DTC). Results: Radio-active iodine (RAI) treatment was performed in 131 patients (91.6%), surgical approach and/or external radiotherapy in 68 patients (47.6%), and anti-resorptive bone-active drugs in 32 patients (22.4%; in 31 zoledronate and in one denosumab). At the start of treatment, 24 patients (75.0%) receiving anti-resorptive bone-active drugs had at least one clinical skeletal-related event (SRE) (p < 0.001). One or more clinical SREs (pathological fractures and/or malignant hypercalcemia and/or spinal cord compression) developed in 53 patients (37.1%). Development of SREs was significantly associated with metachronous BM (hazard ratio (HR) 2.04; p = 0.04), localization of BM to cervical spine (HR 3.89; p = 0.01), and lack of avid RAI uptake (HR 2.66; p = 0.02). Thirty-nine patients (27.3%) died in correlation with development of SREs (HR 6.97; p = 0.006) and localization of BM to the hip (HR 3.86; p = 0.02). Moreover, overall mortality was significantly decreased by RAI therapy (HR 0.10; p = 0.02), whereas no significant effects were induced by bone-active drugs (p = 0.36), external radiotherapy (p = 0.54), and surgery (p = 0.43) of BM. Conclusions: SREs are very frequent in BM from DTC and they impact patient survival. In the real life, the use of bone-active drugs is currently limited to zoledronate in patients with pre-existing SREs. In this clinical setting, RAI therapy, but not zoledronate, decreased mortality. © 2017 Springer Science+Business Media, LLC
AB - Purpose and Patients: The M.O.S.CA.TI. (Metastases of the Skeleton from CArcinoma of the ThyroId) is a multicenter, retrospective study investigating the real-life outcome and management of bone metastases (BM) in 143 patients (63 M, 80 F; median age 64 years, range 11–87) with differentiated thyroid carcinoma (DTC). Results: Radio-active iodine (RAI) treatment was performed in 131 patients (91.6%), surgical approach and/or external radiotherapy in 68 patients (47.6%), and anti-resorptive bone-active drugs in 32 patients (22.4%; in 31 zoledronate and in one denosumab). At the start of treatment, 24 patients (75.0%) receiving anti-resorptive bone-active drugs had at least one clinical skeletal-related event (SRE) (p < 0.001). One or more clinical SREs (pathological fractures and/or malignant hypercalcemia and/or spinal cord compression) developed in 53 patients (37.1%). Development of SREs was significantly associated with metachronous BM (hazard ratio (HR) 2.04; p = 0.04), localization of BM to cervical spine (HR 3.89; p = 0.01), and lack of avid RAI uptake (HR 2.66; p = 0.02). Thirty-nine patients (27.3%) died in correlation with development of SREs (HR 6.97; p = 0.006) and localization of BM to the hip (HR 3.86; p = 0.02). Moreover, overall mortality was significantly decreased by RAI therapy (HR 0.10; p = 0.02), whereas no significant effects were induced by bone-active drugs (p = 0.36), external radiotherapy (p = 0.54), and surgery (p = 0.43) of BM. Conclusions: SREs are very frequent in BM from DTC and they impact patient survival. In the real life, the use of bone-active drugs is currently limited to zoledronate in patients with pre-existing SREs. In this clinical setting, RAI therapy, but not zoledronate, decreased mortality. © 2017 Springer Science+Business Media, LLC
U2 - 10.1007/s12020-017-1455-6
DO - 10.1007/s12020-017-1455-6
M3 - Article
VL - 59
SP - 90
EP - 101
JO - Endocrine
JF - Endocrine
SN - 1355-008X
IS - 1
ER -