Differentiated Thyroid Carcinomas: Treatment of Distant Metastases

During the 26-year period from 1947 to 1973, 333 patients with differentiated thyroid carcinomas were treated with sodium iodide I 131 post-operatively. Thirty-six of these (10.6%) had metastases to lung or bone or both. The mean age at the time of diagnosis was 36.1 years (range, 6 to 69 years). Mortality from thyroid carcinomas was 27.8%. Average follow-up interval from diagnosis was 19.8 years for those with papillary carcinomas and lung metastases and 23.0 years for those with follicular carcinomas and lung metastases. Although seven of ten patients with bone metastases died, the five-year survival was 100% in this group. The average dose of sodium iodide I 131 was 383.2 millicuries for papillary distant metastases and 571.2 millicuries for follicular metastases. Total thyroidectomy prior to treatment of distant metastases with sodium iodide I 131 is important for successful management.