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Ann Thorac Surg 2001;72:1906-1908
© 2001 The Society of Thoracic Surgeons

Original article: general thoracic

Thoracic metastasectomy in thyroid malignancies

Aristotle D. Protopapas, FRCSa, Andrew G. Nicholson, DMb, Louiza Vini, FRCRc, Clive L. Harmer, FRCRc, Peter Goldstraw, FRCS*a

a Department of Thoracic Surgery, Royal Brompton Hospital, London, England, United Kingdom
b Department of Histopathology, Royal Brompton Hospital, London, England, United Kingdom
c Thyroid Unit, Royal Marsden Hospital, London, England, United Kingdom

Accepted for publication June 27, 2001.

* Address reprint requests to Dr Goldstraw, Department of Thoracic Surgery, Royal Brompton and Harefield NHS Trust, Sydney St, London, England SW3 6NP, United Kingdom
e-mail: p.goldstraw{at}rbh.nthames.nhs.uk

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 metastatic 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, Hürthle cell in 3, and medullary in 3. Indication was either "bulky" disease (8 patients) or poor response to radiotherapy (8 patients). We performed 11 sternotomies and five thoracotomies. Operative mortality was 6.25%. Operative morbidity was 6.25%. Mean survival was 39.5 months (0 to 144). Nine patients died during follow-up (mean survival of 41.2 months). Six patients survived, 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 subgroup of patients where radiotherapy had failed or was deemed inappropriate because of the size or location of the tumor. Further follow-up and more observations will be required for evaluating these preliminary findings.






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Copyright © 2001 by The Society of Thoracic Surgeons.