The role of operations for distantly metastatic well-differentiated XXXX .

@entity1 @entity9856 @entity174 @entity602 @entity158 @entity3 @entity259
BACKGROUND: The role of operations for distantly metastatic well-differentiated @entity259 (DTC) is poorly defined. We review the indications for operation for metastatic DTC. METHODS: This study consists of 260 @entity1 treated between 1941 and 2000 for metastatic DTC, of which 59 (23%) underwent operations. Median follow-up was 7 years (range, 1 to 49 years). @entity3 were identified clinically in 157 (60%) and radiologically in 103 (40%) @entity1 . The disease-specific survival was estimated with the Kaplan-Meier method. RESULTS: Twenty-four @entity1 (9%) were disease-free with resection. Palliative resection was indicated for @entity158 , pathologic @entity174 , or symptomatic @entity602 (35/260, 14%). @entity1 who could undergo complete metastasectomy survived longer than those having incomplete/palliative resection or nonoperative treatment for metastatic @entity9856 (5-year disease-specific survival, 78% vs 43% vs 46%, P =.03). CONCLUSIONS: Solitary distant @entity3 of DTC amenable to complete resection is infrequent. Complete metastasectomy may be associated with improved survival for localized distant disease. Palliative resection is indicated to improve quality of life for symptomatic distant @entity3 .
