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Background <p>Notwithstanding the generally positive outlook for differentiated thyroid cancer (DTC), metastatic differentiated thyroid cancer (mDTC) remains a lethal disease. In light of the current insufficient information regarding mortality causes in mDTC, our research endeavored to elucidate the factors contributing to death in patients diagnosed with mDTC.</p> Materials and methods <p>A cohort of 187,747 differentiated thyroid cancer (DTC) cases was extracted from the Surveillance, Epidemiology, and End Results–17 cancer registry database (2000–2020) and identified 4749 patients diagnosed with mDTC. The study estimated the cumulative mortality associated with thyroid cancer, subsequent cancers, and non-cancer-related causes. Standardized mortality ratios (SMR) were employed to evaluate the disparities between observed and expected mortality rates in mDTC patients.</p> Results <p>In the DTC cohort, with a median follow-up of 70&#xa0;months, 17,582 patients (9.4%) succumbed during the follow-up period. In the mDTC cohort, 2046 deaths (43.1%) occurred, with the 5-year cumulative mortality being highest for brain and liver metastases at 53.1% and 49.0%, respectively. During follow-up, 7.1% of patients with mDTC expired from subsequent cancers, with the largest proportion attributed to lung cancer. During the mDTC period, the most prevalent cause of non-cancer mortality was cerebrovascular diseases (SMR, 1.45; 95% CI, 1.05–1.94).</p> Conclusions <p>Non-cancer-related mortality constitutes a substantial proportion of mDTC and exhibits an increasing trend. Enhanced attention should be directed toward the management of mDTC survivors, with individualized treatment and follow-up plans tailored to patient-specific factors, while providing comprehensive guidance regarding potential future health risks.</p>

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Causes of death among patients with metastatic differentiated thyroid cancer

  • 期刊论文

  • 发表日期：

    2025年7月7日

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  • Q. Liu,
  • B. Ma,
  • M. Song,
  • H. Sun,
  • H. Zhang

摘要

Background

Notwithstanding the generally positive outlook for differentiated thyroid cancer (DTC), metastatic differentiated thyroid cancer (mDTC) remains a lethal disease. In light of the current insufficient information regarding mortality causes in mDTC, our research endeavored to elucidate the factors contributing to death in patients diagnosed with mDTC.

Materials and methods

A cohort of 187,747 differentiated thyroid cancer (DTC) cases was extracted from the Surveillance, Epidemiology, and End Results–17 cancer registry database (2000–2020) and identified 4749 patients diagnosed with mDTC. The study estimated the cumulative mortality associated with thyroid cancer, subsequent cancers, and non-cancer-related causes. Standardized mortality ratios (SMR) were employed to evaluate the disparities between observed and expected mortality rates in mDTC patients.

Results

In the DTC cohort, with a median follow-up of 70 months, 17,582 patients (9.4%) succumbed during the follow-up period. In the mDTC cohort, 2046 deaths (43.1%) occurred, with the 5-year cumulative mortality being highest for brain and liver metastases at 53.1% and 49.0%, respectively. During follow-up, 7.1% of patients with mDTC expired from subsequent cancers, with the largest proportion attributed to lung cancer. During the mDTC period, the most prevalent cause of non-cancer mortality was cerebrovascular diseases (SMR, 1.45; 95% CI, 1.05–1.94).

Conclusions

Non-cancer-related mortality constitutes a substantial proportion of mDTC and exhibits an increasing trend. Enhanced attention should be directed toward the management of mDTC survivors, with individualized treatment and follow-up plans tailored to patient-specific factors, while providing comprehensive guidance regarding potential future health risks.