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. 2025 Jul 1;15(1):21932.
doi: 10.1038/s41598-025-08845-y.

Survival benefits of primary tumor resection in metastatic differentiated thyroid cancer: an analysis of SEER data

Jiaqiang Dan #  1 , Jingya Tan #  2 , Yao Guo  1 , Xin Lu  1 , Ying Leng  1 , Renxi Tang  1 , Junyan Li  3 , Junhua Huang  4
Affiliations

Survival benefits of primary tumor resection in metastatic differentiated thyroid cancer: an analysis of SEER data

Jiaqiang Dan et al. Sci Rep. .

Abstract

Metastatic differentiated thyroid cancer (mDTC) can exhibit aggressive growth and disseminate to distant organs, thereby reducing survival rates. The benefits of primary tumor resection (PTR) for patients with mDTC are still debated. In this study, we utilized the Surveillance, Epidemiology, and End Results (SEER) database to evaluate mDTC patients, focusing on the impact of organ-specific metastases and the number of metastatic sites on prognosis, as well as the potential efficacy of PTR as a therapeutic intervention. 904 patients with mDTC at initial diagnosis from 2010 to 2015 were studied. Lung and bone were the most common sites of metastasis. Patients with brain, lung and liver metastasis had significantly worse overall survival (OS) (all p < 0.05) and cancer-specific survival (CSS) (all p < 0.05). Among all the patients, 550 (60.84%) underwent PTR, which was associated with reduced risk of overall mortality (OM) and cancer-specific mortality (CSM) (all p < 0.05). When analyzing different metastatic patterns, PTR significantly lowered the risk of OM and CSM for patients with bone, brain, lung, liver, or distant lymph node (DLN) involvement (all p < 0.05). Surgical resection also improved OS and CSS (both p < 0.05) in patients with multiple organ involvement or one/two metastases. Our findings suggest that PTR may confer benefits to select individuals with metastatic DTC. To validate these results and facilitate their integration into clinical practice, multicenter prospective studies are warranted.

Keywords: Differentiated thyroid carcinoma; Metastatic patterns; Optimal candidates; Primary tumor resection; SEER database.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethical statement and consent to participate: The protocol for this study was approved by the Ethics Committee of Chengdu Fifth People’s Hospital (The Second Clincal Medical College, Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine). As the SEER database was publicly accessible, the present study did not require informed patient consent.

Figures

Fig. 1
Fig. 1
Venn diagram depicting the distribution of metastatic sites.
Fig. 2
Fig. 2
Kaplan-Meier curves illustrating overall (A) and cancer-specificsurvival (B) based on the performance of PTR in the overall cohort.
Fig. 3
Fig. 3
Kaplan-Meier curves illustrating overall and cancer-specific survival based on the performance of PTR in patients with bone (A and B), brain (C and D), distant lymph node (E and F), liver (G and H) and lung metastases (I and J).
Fig. 4
Fig. 4
Kaplan-Meier curves illustrating overall and cancer-specific survival based on the performance of PTR in patients with one (A and B), two (C and D), three (E and F) and four metastatic organs (G and H).
Fig. 5
Fig. 5
Forest plots summarizing the HRs and 95% CIs of overall (A) and cancer-specific mortality (B) in subgroup analyses comparing PTR versus no-PTR (Metastases abbreviated as mets).
See this image and copyright information in PMC

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