Thoracic metastasectomy in thyroid malignancies

Background. Relatively little evidence exists to guide the decision pathway regarding thoracic metastasectomy for thyroid malignancy. Methods. Single-institution 10-year review. Results. Sixteen patients had surgical treatment for intrathoracic metastat ic thyroid malignancy: 12 men and 4 women, mean age 43.7 years (range 19 to 77). Histopathologic type was papillary in 6 cases, follicular in 4, Hurth le cell in 3, and medullary in 3. Indication was either "bulky" disease (8 patients) or poor response to radiotherapy (8 patients). We performed 11 st ernotomies and five thoracotomies. Operative mortality was 6.25%. Operative morbidity was 6.25%. Mean survival was 39.5 months (0 to 144). Nine patien ts died during follow-up (mean survival of 41.2 months). Six patients survi ved, 4 free of disease (mean survival 70 months) and 2 with further relapse (mean survival 17 months). Five-year survival was 32.5%. Conclusions. The cohort studied is one of the largest in the literature on the topic. Surgical treatment achieved a reasonable survival in a small sub group of patients where radiotherapy had failed or was deemed inappropriate because of the size or location of the tumor. Further follow-up and more o bservations will be required for evaluating these preliminary findings. (C) 2001 by The Society of Thoracic Surgeons.