Yusuf Dundar MD, Quinton Mandle, Julie Samantray MD, Jeffrey Hotaling MD, Syed M Rizi, John Cramer MD, Ho-Sheng Lin MD, Syed N Raza MD
Background: There is currently no consensus on the role of pulmonary metastasectomy (PM) for thyroid malignancies. The main objective of this study is to determine if there is any survival benefit to PM and determine good candidates for metastasectomy.
Methods: A systematic review of relevant studies was performed, evaluating articles identified using the PubMed, Cochrane, and MEDLINE databases according to PRISMA-guidelines.
Results: The initial literature search yielded 18 articles of which 7 met inclusion criteria. Only data on thyroid cancers were included in the systematic review. A total of 174 patients who underwent PM were analyzed. The mean age was 54.8 (range: 10–90), and 52.5% of patients were female. The overall absolute 5-year survival rate was 67.7% (range: 32.5–84.0%) for patients undergoing PM. The reported post-surgical complication rate overall was 14.4% and two peri-operative deaths were reported. Three papers reported the following as good prognostic factors: Papillary histology, younger age (<45 years), disease free interval >3 years, R0 (microscopic margin free) resection, systematic lymphadenectomy, thyroglobulin <10 ng/mL, and thyroglobulin reduction >80% after metastasectomy.
Conclusion: This study is the first systematic review evaluating the clinical role of PM for thyroid cancer in the literature to date. PM may offer prolonged survival over traditional therapy for selected patients.
Keywords: Thyroid malignancy, pulmonary metastasis, metastasectomy, survival outcomes
Article citation: Dundar Y, Mandle Q, Samantray J, Hotaling J, Rizi SM, Cramer J, Lin H-S, Raza SN. Clinical value of pulmonary metastasectomy for thyroid malignancies: a systematic review and meta-analysis. The Southwest Respiratory and Critical Care Chronicles 2019;7(31):24–33
From: Department of Otolaryngology-Head and Neck Surgery (YD, QM, JH, SMR, JC, HSL, SNR), Wayne State University School of Medicine, Detroit, MI; Barbara Ann Karmanos Cancer Institute (YD, JH, JC, HSL, SNR), Wayne State University School of Medicine, Detroit, MI; Department of Internal Medicine (JS), Wayne State University School of Medicine, Detroit, MI.
Submitted: 9/22/2019
Accepted: 10/16/2019
Reviewer: Marcella Rivas MD, Duke Appiah PhD
Conflicts of interest: none
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