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• W2114834441 abstract "Dear Editor,We read with great interest the paper by Kasai et al. [4] published in International Orthopaedics. We congratulate the authors on their work. We agree with them on one point and disagree on another one. The first is that a long time (above 5 years) between diagnosis of the thyroid cancer and the operation for the spinal metastases would be a good prognostic sign. However, we disagree that the “surgical strategy for spinal metastases” developed by us [5] would not expect survival in patients with spinal metastases from thyroid cancer.In 2002, we reviewed 14 cases of thyroid cancer spinal metastases treated between December 1984 and July 2000 in the Orthopedic Department, Kanazawa University, Kanazawa, Japan. The patients included 9 females and 5 males. The primary tumor was follicular carcinoma in 10 and papillary carcinoma in 4. Four patients (28.6%) had presented with spinal metastases without a history of thyroid cancer and one patients presented with spinal metastases 14 years after excision of a thyroid lesion diagnosed as follicular adenoma. The remaining 9 patients developed their spinal metastases after a mean of 8.2 years from diagnosis of thyroid cancer (range 0.25–22 years). In total, those 14 patients received 25 operations [1]. When we applied the criteria suggested by Kasai et al. [4] on our patients, we found that five patients had their spinal metastases 5 years or more after diagnosis of thyroid cancer primary tumour; four out of those five patients (80%) survived for more than 5 years (mean 98.5, range 78–124 months). The fifth patient died 33 months after the operative intervention for the spinal metastases [1]. So, we completely agree with Kasai et al. [4] that a long time span (above 5 years) between diagnosis of the thyroid cancer and the operation for the spinal metastases would be a good prognostic sign with about 80% of the patients surviving for more than 5 years. However, we disagree with the conclusion regarding the invalidity of the surgical strategy for spinal metastases in survival predilection in cases of thyroid cancer. We reviewed the validity of the surgical strategy for spinal metastases in the same 14 cases of thyroid cancer spinal metastases. The strategy scores were detected for the 25 operations, whether performed before or after development of the strategy. Postoperative survival was detected and compared between different scores. Total scores after strategy application were 2 (7 operations; 28%), 3 (11 operations; 44%), 4 (2 operations, 8%) and 5 (5 operations, 20%). No patient had scores from 6–10 at the time of any operation. Survival after operations with scores 2, 3, 4 and 5 were 75.6 ± 25.8, 32.6 ± 27.8, 23 and 18.4 ± 9.8 months, respectively. Survival correlates with the score with correlation coefficient equals -0.68 (P = 0.005). Survival with scores of 2 and 3 after operation (candidates of long-term local control) was 51.4 ± 34.1 months while survival after operations for patients having the scores of 4 and 5 (candidates of middle-term local control) was 19.7 ± 10.5 months. The difference was statistically significant (P = 0.04) [2, 3]. From these results, we can conclude that the surgical strategy for spinal metastases would successfully predict survival in patients with thyroid cancer spinal metastases." @default.
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• W2114834441 date "2007-08-24" @default.
• W2114834441 modified "2023-10-18" @default.
• W2114834441 title "Comment on Kasai et al.: Clinical profile of long-term survivors of breast or thyroid cancer with metastatic spinal tumours" @default.
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• W2114834441 doi "https://doi.org/10.1007/s00264-007-0426-6" @default.
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