DIFFERENT FEATURES OF PULMONARY METASTASES IN DIFFERENTIATED THYROID-CANCER - NATURAL-HISTORY AND MULTIVARIATE STATISTICAL-ANALYSIS OF PROGNOSTIC VARIABLES

We studied 134 patients with differentiated thyroid cancer and pulmona ry metastases. All were treated with total or near total thyroidectomy , radioiodine and L-thyroxine. The prognostic value of the following v ariables in three groups of patients were evaluated by univariate and multivariate analysis: age at diagnosis, sex, histologic type, tumor e xtension, cervical lymph node metastases, mediastinic metastases, pres ence of metastases in distant sites other than lungs (multiple distant metastases) and morphological (chest x-rays) and functional (I-131 up take) features of lung metastases. Univariate analysis identified pati ent age (p < 0.0001), morphological and functional features of lung me tastases (p < 0.0001), presence of multiple distant metastases (p < 0. 0001) and histologic type (p = 0.04) as significant prognostic factors . Multivariate analysis showed only morphological (p = 0.001 4) and fu nctional (p < 0.0001) features of lung metastases and the presence of multiple distant metastases (p = 0.01) as significant and independent variables. The data show that early (pre-radiological) scintigraphic d iagnosis and I-131 therapy of lung metastases appear to be the most im portant elements in obtaining both a significant improvement in surviv al rate and a prolonged disease-free time interval in these patients.